Activity Description:

A spinal epidural abscess (SEA) is inflammation with pus within the epidural space. The clinical presentation may be insidious, and diagnosis is often difficult in the early stages. Classic features include back pain, fever, and neurologic deficit, but only a minority of patients have all three features. Spinal epidural abscess has a high morbidity and mortality if untreated.

References:

1. Bond A, Manian FA. Spinal epidural abscess: a review with special emphasis on earlier diagnosis. Biomed Res Int. 2016 Dec 1 [Epub ahead of print].
2. Sharfman ZT, Gelfand Y, Shah P, et al. Spinal epidural abscess: a review of presentation, management, and medicolegal implications. Asian Spine J. 2020 Oct;14(5):742-59.
3. Sendi P, Bregenzer T, Zimmerli W. Spinal epidural abscess in clinical practice. QJM. 2008 Jan;101(1):1-12.
4. Expert Panel on Neurological Imaging; Ortiz AO, Levitt A, Shah LM, et al. ACR Appropriateness Criteria® suspected spine infection. J Am Coll Radiol. 2021 Nov;18(suppl 11):S488-501.
5. Suppiah S, Meng Y, Fehlings MG, et al. How best to manage the spinal epidural abscess? A current systematic review. World Neurosurg. 2016 Sep;93:20-8. 
6. Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2021. Crit Care Med. 2021 Nov 1;49(11):e1063-143.

Target Audience: 

Specialties - Internal Medicine

Professions - Physician

Learning Objectives:

• Identify the indications and contraindications for new modalities in the prevention, diagnosis, and treatment of Internal Medicine conditions
• Examine risk factors, symptoms, and exam findings associated with spinal epidural abscess
• Identify pitfalls leading to erroneous interpretation of the tests for spinal epidural abscess
• Formulate prioritized differential diagnoses for the clinical presentations of specific medical conditions, diagnoses, and diseases.
• Apply clinical guidelines to patients under their care with an understanding of the rationale behind the guidelines and the expected outcomes of specific medical conditions, diagnoses, diseases.
• Integrate research techniques related to specific medical conditions, diagnoses, and diseases, into their own clinical, translational or basic science research.

Moderator:

Non-faculty contributors and others involved in the planning, development and editing/review of the content have no relevant financial relationships to disclose with ineligible companies.*

*Ineligible companies – Companies whose primary business is producing, marketing, selling, re-selling or distributing healthcare products used by or on patients.

Accreditation:

The HCA Healthcare Continental Division is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. 

Credit Designation:

The HCA Healthcare Continental Division designates this live activity for a maximum of 1.0 AMA PRA Category 1^TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Commercial Support:  

This Activity was developed without support from any ineligible company.*The ACCME defines ineligible companies as those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. Note: The ACCME does not consider providers of clinical service directly to patients to be commercial interests – unless the provider of clinical services is owned, or controlled by, and ACCME defined ineligible company.

Disclosure: 

The HCA Healthcare Continental Division is committed to providing CME that is balanced, objective, and evidenced-based. In accordance with the Accreditation Council for Continuing Medical Education Standards for Integrity and Independence all parties involved in content development are required to disclose all conflicts of interest with ACCME defined ineligible companies. The HCA Healthcare Continental Division has identified, reviewed, and mitigated all conflicts of interest that speakers, authors, course directors, planners, peer reviewers, or relevant staff disclose prior to the delivery of any educational activity. The CME planning committee who are in a position to control the content of this CME Activity, have no relevant financial relationships with ineligible companies to disclose.