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To emphasize the importance of timely diagnosis of spinal epidural abscess,thirteen patients admitted to a single general hospital are presented.In 10 patients,diagnosis was not appreciated at the time of presentation.After treatment,four remained paraparetic and three died.Nine patients had predisposing factors,including seven with infections at sites other than the spinal canal.Staphylococcus aureus was the predominant organism.Outcome was equally devastating for the seven patients with acute and the six patients with chronic infections.Gadolinium-enhanced magnetic resonance imaging was the most useful diagnostic test,and we recommend that it be performed promptly in any patient with clinical features suggesting spinal epidural abscess since early surgical drainage and appropriate antibiotics may yield a favorable outcome. |
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alcoholism
cerebrospinal fluid
cerebrospinal fluid,abnormal
diabetes mellitus
emergencies,neurologic
empyema,epidural-spinal
fever
gadolinium
immunosuppression
leg weakness,bilateral
misdiagnosis
mortality
MRI
MRI,abnormal
MRI,contrast enhanced
MRI,spine
pain,back
pain,leg
paraparesis
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