Imaging studies in spinal epidural abscess. Five case-reports.

Five cases of spinal epidural abscess seen over a seven-year period at the radiology department of the Ibn Rochd Teaching Hospital in Casablanca, Moro cco, are reported. There were two children with a history of spinal injury, a diabetic woman, and two other adults with discitis. Four patients had ne urologic signs and fever. The diagnosis of epidural abscess was made by com puted myelotomography in three cases and by magnetic resonance imaging (MRI ) in two. Marked extension of the abscess was noted in four cases. The cerv ical and thoracic segments were most commonly affected. The causative organ ism was the tubercle bacillus in two cases, a staphylococcus in two cases, and another pyogenic organism in one case. One of the two children underwen t surgery, whereas the other four patients were treated only by conservativ e means. The outcome was unfavorable in four patients. The remaining patien t had a small tuberculous abscess that resolved completely under antituberc ulous drug therapy. Spinal epidural abscess is a rare neuroradiological eme rgency. The lack of specificity of the presenting symptoms illustrates the usefulness of imaging studies, most notably MRI, for establishing the diagn osis, making treatment decisions, and monitoring the course.