PMC5159689_01
Computed tomography abdomen/pelvis with intravenous contrast showing a 5.2 x 4.2 cm amorphous, heterogeneously isodense lesion involving the right piriformis muscle at the level of the right greater sciatic foramen (arrow)
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F1
Diagnostic studies revealed a peripheral white blood cell count of 30000, and on computed tomography (CT) of the abdomen/pelvis, an abnormal heterogeneous fluid collection involving the right piriformis muscle was detected [Figure 1].
Sagittal T2-weighted magnetic resonance imaging (MRI) scan depicting spinal epidural abscess compressing the cervical cord posteriorly with blockage of cerebrospinal fluid flow (a). Sagittal T2-weighted MRI scan demonstrating spinal epidural abscess extending down the thoracic (b), and lumbar (c) vertebrae compressing the cord posteriorly
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F2
MR studies of the cervical, thoracic, and lumbar spine documented a posterior SEA extending from C2 to the sacrum with significant posterior compression of the cord [Figure 2]. Notably, the patient's motor strength worsened rapidly to 2/5 in all extremities and then to just 1/5 in the upper and 0/5 strength in the lower extremities, warranting emergency surgery [Figure 2].