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Risk Factors for Spinal Epidural Abscesses
Building on Dr. Corwell's pearl from last week concerning Spinal Epidural Abscess, risk factors for Spinal Epidural Abscesses other than IV drug abuse are:
- Diabetes
- ESRD
- Septicemia
- HIV infection
- Malignancy
- Morbid obesity
- Long-term corticosteroid use
- Alcoholism
- Infection at a distal site
- Indwelling catheters
- Spinal surgery
The infection can occur via three routes 1) hematogenous spread 2) Direct Extension from a local infection such as osteoomyelitis, and 3) iatrogenic introduction which is thought to be responsible for 14-22% of the cases. A catheter in the epidural space for more than 2 days has a infection rate of 4.3%.
References
Marc Tompkins, Ian Panuncialman, Phillip Lucas, Mark Palumbo. Spinal Epidural Abscess The Journal of Emergency Medicine, Volume 39, Issue 3, September 2010, Pages 384-390