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Spinal Epidural Abscess — SCE Infectious Diseases MCQ

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HardCNS InfectionSpinal Epidural AbscessSCE Infectious Diseases

MRI confirms a thoracic spinal epidural abscess with cord compression in a febrile patient with progressive paraparesis and MSSA bacteraemia. What is the immediate priority?

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Correct answer: B — Emergency decompression and drainage plus intravenous antistaphylococcal therapy

The best answer is “Emergency decompression and drainage plus intravenous antistaphylococcal therapy”. Neurological deficit and cord compression make source control time critical; blood and operative cultures guide therapy, but antibiotics alone risk irreversible paralysis in this presentation. Deep surgical infection needs microbiological diagnosis and source control; retained necrotic tissue or infected prosthetic material limits antimicrobial cure.

Reference: NICE NG125: surgical site infections: https://www.nice.org.uk/guidance/ng125/chapter/Recommendations