A rare case of full recovery following delayed presentation of paraplegia secondary to thoracic epidural abscess: A case report and review of the literature

BACKGROUND: Timely diagnosis and prompt management of thoracic epidural abscesses are vital to preventing the onset of irreversible paralysis and death. CASE DESCRIPTION: A 39-year-old female was managed initially for non-specific chest pain for 10 days (i.e., diagnosis of respiratory tract infection). After she developed paraplegia (0/5 motor function), a T10 sensory level, and acute urinary retention, a thoracic magnetic resonance with contrast revealed a T3–T7 spinal epidural abscess with cord compression. On review of her lab studies revealed a white blood cell count of 11.03 × 10(9)/L and a C-reactive protein level of 122 mg/dL. Following a T3–T7 laminectomy with evacuation of an extradural empyema, she fully recovered. CONCLUSION: This case report emphasizes the need for early recognition, diagnosis, and treatment of thoracic epidural abscesses that are too often mis-diagnosed as respiratory infections.