A Cut Above

Marsh et al present a case of a 40-year-old man who's diagnosis did not explain all of his signs and symptoms--particularly when they took a calamitous turn. The patient had a history of L4-L5 laminectomy for lumbar radiculopathy, presented after 1 week of progressively worsening abdominal pain, difficulty walking, and fever. The diagnostic tests show that a posterior epidural abscess was discovered proximal to the herniated intervertebral disk at L3-L4 and extending from T7 to T10. Their patient underwent emergency spinal cord decompression and epidural abscess drainage and was transferred to a rehabilitation facility, continued intravenous vancomycin for 6 weeks.