Beyond Risk Factors: Spinal Epidural Abscess in a Young, Healthy Patient

Epidural abscess is a rare complication of neuraxial techniques, which, when left unnoticed, can lead to significant neurological deficits and poor outcomes. Identification of patients at high risk and the conduct of a strict aseptic technique are some of the measures that play an important role in epidural abscess prevention. Prompt recognition and treatment of epidural abscesses are essential. Close monitoring in the perioperative period for new-onset clinical signs and symptoms is of major importance. When an epidural abscess is suspected, early laboratory assessment and magnetic resonance imaging (MRI) are indicated. Treatment options include early empiric and posteriorly antibiogram-guided antibiotic therapy and surgical decompression of the epidural abscess. This case presents a young male patient with no significant medical history or predisposing risk factors who developed an epidural abscess following epidural catheter placement for osteosynthesis of a left tibial plateau fracture. The patient's absence of additional predisposing conditions, besides two attempts at epidural catheter placement, underscores the complexity and unpredictability of such infections.