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Case Reports in Orthopedics
Volume 2014 (2014), Article ID 245013, 3 pages
http://dx.doi.org/10.1155/2014/245013
Case Report

Ocular Infection Preceding Major Epidural Abscess

Hutt Valley DHB, Private Bag 31907, Wellington, Lower Hutt 5040, New Zealand

Received 6 July 2014; Revised 13 September 2014; Accepted 23 September 2014; Published 30 September 2014

Academic Editor: Ali F. Ozer

Copyright © 2014 Liam Dunbar and Ryan Johnstone. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Staphylococcal bacteremia is an important clinical entity. A 74-year-old lady presented with an isolated staphylococcal ocular infection; this was treated with a short course of antibiotics, a prolonged course of steroids, and discharge from hospital with outpatient clinic followup. She represented three weeks later to the emergency department with back pain, raised inflammatory markers, and positive blood cultures. On magnetic resonance imaging (MRI), an extensive epidural collection was seen. This was surgically decompressed, and she was treated with appropriate intravenous antibiotics. Despite a complicated postoperative course, she made an excellent recovery. This case reviews the important clinical and radiological features of the presentation of a major epidural abscess and it also suggests a potentially unusual primary source. The clinician is reminded to always have a high index of suspicion regarding staphylococcal bacteremia and the potential for seeding to the epidural space.