Describe the clinical presentation of an epidural abscess

Epidural abscess can result from hematogenous spread, local extension, or direct inoculation. This condition is usually found in adults; risk factors include intravenous drug abuse, diabetes mellitus, prior spine trauma, renal failure, and pregnancy. The majority of cases are located in the thoracic spine. The initial presentation includes localized pain and fever with elevation of the ESR, CRP, and leukocyte count. Blood cultures are positive in 60% of patients. Without treatment, significant neurologic deficits occur and eventually paralysis may develop.

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