Rare Gram-Negative Spinal Epidural Abscess Due to Klebsiella pneumoniae Bacteremia: A Case Report

Spinal epidural abscesses (SEA) are rare but potentially devastating infections with high morbidity and mortality. Most often, a SEA is caused by <i>Staphylococcus aureus</i> and, on rare occasions, by Gram-negative bacteria such as <i>Klebsiella pneumoniae</i>. The incidence of SEA appears to be rising due to increased spinal instrumentation and enhanced detection with magnetic resonance imaging (MRI). In this case report, we discuss a case of a 74-year-old male patient with <i>K. pneumoniae</i> bacteremia secondary to a urinary tract source, complicated by lumbar SEA, L4-L5 osteomyelitis, and vertebral fracture requiring urgent decompression. The patient was successfully treated with surgical drainage and six weeks of intravenous ceftriaxone. This case highlights the importance of maintaining a high index of suspicion for rare causative organisms of SEA in patients presenting with systemic infection and back pain.