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June 1978

Tuberculous Epidural Abscess Without Osteomyelitis

Arch Neurol. 1978;35(6):397. doi:10.1001/archneur.1978.00500300071019

To the Editor.—  We have recently seen a case of tuberculous epidural abscess without osteomyelitis. A search of the world's literature has shown only three such cases.

Report of a Case.—  A 44-year-old woman was admitted for intermittent fever and progressively severe left buttock and back pain radiating to the left leg. There had been no antecedent trauma or tuberculosis.Rectal temperature was 40.5° C. Noticeable percussion tenderness was noted over the lower lumbar spine, without local mass or erythema. There was diminished sensation in the L5-S1 dermatome. Noticeable pain and spasm were evident on raising of the straight left leg. Hemogram and urinalysis were unrevealing; ESR rate was 100 mm/hr. Roentgenograms of chest and lumbosacral spine, with tomography, were normal. Intradermal testing, with tuberculin antigen test, with 5 tuberculin units, produced 15-mm induration. Examination of the spinal fluid was unrevealing. A scan of the lumbosacral spine was normal.Myelography