Building on Dr. Corwell's pearl from last week concerning Spinal Epidural Abscess, risk factors for Spinal Epidural Abscesses other than IV drug abuse are:
Diabetes
ESRD
Septicemia
HIV infection
Malignancy
Morbid obesity
Long-term corticosteroid use
Alcoholism
Infection at a distal site
Indwelling catheters
Spinal surgery
The infection can occur via three routes 1) hematogenous spread 2) Direct Extension from a local infection such as osteoomyelitis, and 3) iatrogenic introduction which is thought to be responsible for 14-22% of the cases. A catheter in the epidural space for more than 2 days has a infection rate of 4.3%.
References
Marc Tompkins, Ian Panuncialman, Phillip Lucas, Mark Palumbo. Spinal Epidural AbscessThe Journal of Emergency Medicine, Volume 39, Issue 3, September 2010, Pages 384-390
