A 60-year-old diabetic man presents with fever, severe back pain, and rapidly progressive bilateral lower limb weakness over 48 hours. MRI with contrast shows a dorsal epidural collection with ring enhancement from T8-T10 compressing the cord. The most common causative organism is:

• A Mycobacterium tuberculosis
• B Streptococcus pneumoniae
• C Escherichia coli
• D Staphylococcus aureus ✓

Explanation

Spinal epidural abscess is a neurosurgical emergency presenting with the classic triad of fever, back pain, and neurological deficit. The most common organism is Staphylococcus aureus (accounting for roughly two-thirds of cases), usually from hematogenous spread or direct extension. MRI with contrast is diagnostic. Tuberculosis causes Pott's disease (spondylodiscitis), which is more indolent and typically involves the disc and adjacent vertebral bodies rather than a dorsal epidural collection.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.