We describe a case of severe neurological injury secondary to an epidural abscess that developed during the course of critical illness. It was caused by an oesophageal perforation that developed into an invasive abscess while the patient was being treated in the intensive care unit (ICU) for respiratory failure. We discuss spinal epidural abscesses, and the importance of searching for an alternative diagnosis in patients with weakness.
TangHJLinHJLiuYCLiCM. Spinal epidural abscess – experience with 46 patients and evaluation of prognostic factors. J Infect2002;45:76–81.
5.
MackenzieARLaingRBSSmithCC. Spinal epidural abscess: The importance of early diagnosis and treatment. J Neurol Neurosurg Psychiatry1998;65:209–12.
6.
BoulisNMArmstrongWSChandlerWFOrringerMB. Epidural abscess: A delayed complication of esophageal stenting for benign stricture. Ann Thorac Surg1999;68:568–70.
7.
MersolJVKozarekRA. Spine complications of stent placement. Gastrointest Endosc2002;55:241.
8.
DannerRLHartmanBJ. Update on spinal epidural abscess: 35 cases and review of the literature. Rev Infect Dis1987;9:265–74.
9.
DarouicheRO. Spinal epidural abscess. N Engl J Med2006;355:2012–20.
10.
OehmichenFPohlMSchlosserR. Critical-illness-Polyneuropathie und –Polymyopathie. Wie sicher ist die klinische Diagnose bei Patienten mit Weaning-Versagen?Nervenartz2012;83:220–25.
11.
StevensRDDowdyDWMichaelsRK. Neuromuscular dysfunction acquired in critical illness: A systematic review. Intensive Care Med2007;33:1876–91.
12.
StevensRDMarshallSACornblathDR. A framework for diagnosing and classifying intensive care unit-acquired weakness. Crit Care Med2009;37(Suppl.):S299–S308.
13.
MaherJRutledgeFRemtullaH. Neuromuscular disorders associated with failure to wean from the ventilator. Intensive Care Med1995;21:737–43.
14.
LacomisDPetrellaJTGiulianiM. Causes of neuromuscular weakness in the intensive care unit: A study of ninety-two patients. Muscle Nerve1998;21:610–17.