Spinal epidural abscess following glossectomy and neck dissection: A case report

• Lumbar spinal epidural abscess is uncommon following head and neck surgery.
• Isolating Klebsiella pneumoniae as the etiologic pathogen is even more rare.
• Early diagnosis is paramount with magnetic resonance imaging being the study of choice.
• The preferred treatment strategy consists of surgical decompression and drainage combined with intravenous antibiotics.

IntroductionSpinal epidural abscess is an uncommon but potentially life threatening entity that rarely occurs after otolaryngology procedures.Presentation of caseWe report a case of a diabetic patient who presented with a lumbar spinal epidural abscess eight days after head and neck oncologic surgery. Magnetic resonance imaging revealed an L4 spinal epidural abscess. Cultures from the spinal epidural abscess, blood, urine, and the previous neck incision grew Klebsiella pneumoniae. The patient recovered neurologic function after surgical decompression and drainage, long-term intravenous antibiotics, and physical therapy.DiscussionThe development of postoperative spinal epidural abscess is rare after otolaryngology procedures but has been reported in the cervical epidural space. To our knowledge, lumbar spinal epidural abscess has not yet been reported after head and neck oncologic surgery. Even more unique is the presence of the pathogen K. pneumoniae.ConclusionA high index of suspicion of this potential outcome is paramount as early recognition and intervention are keys to recovery of neurologic function.