Abstract
Musculoskeletal tuberculosis is known for its ability to present in various forms and guises at different sites. Tubercular spinal epidural abscess (SEA) is an uncommon infectious entity. Its presence without associated osseous involvement may be considered an extremely rare scenario. We present a rare case of tubercular SEA in an immune-competent 35-year-old male patient. The patient presented with acute cauda equina syndrome and was shown to have multisegmental SEA extending from D5 to S2 vertebral level without any evidence of vertebral involvement on MRI. The patient made an uneventful recovery following surgical decompression and antitubercular chemotherapy. The diagnosis was confirmed by histopathological demonstration of Mycobacterium tuberculosis in drained pus. Such presentation of tubercular SEA has not been reported previously in the English language based medical literature to the best of our knowledge.
Highlights
Spinal epidural abscess (SEA) represents a severe, generally pyogenic, infection of the epidural space which may compress neural elements and require urgent surgical intervention to avoid permanent neurological deficit [1]
We present an extremely rare case of spinal epidural abscess of tubercular origin involving the thoracic-lumbar-sacral region of the spine without osseous lesions
Most spinal infections in developed regions are the result of pyogenic organisms, whereas non-pyogenic organisms are responsible for most spinal infections in areas of the developing world, and in the immunocompromised population of developed nations [1,8]
Summary
Spinal epidural abscess (SEA) represents a severe, generally pyogenic, infection of the epidural space which may compress neural elements and require urgent surgical intervention to avoid permanent neurological deficit [1]. Introduction Spinal epidural abscess (SEA) represents a severe, generally pyogenic, infection of the epidural space which may compress neural elements and require urgent surgical intervention to avoid permanent neurological deficit [1]. Diagnosis and early decompression remain the two important predictors of successful neurological outcome in acute cauda equina syndrome [5,6].
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