Introduction: Spinal epidural abscess is a serious condition associated with possible catastrophic neurologic sequelae. Acting through a mass effect, an infectious collection threatens spinal cord perfusion by compressing the surrounding vasculature. We discuss the unique presentation of a urinary tract infection-associated lumbar spinal epidural abscess in an otherwise healthy 47-year-old male.

Case Report: A 47-year-old male with no past medical history presented with complaints of worsening low back pain following a trip to India approximately two months prior to his first orthopaedic spine surgery consultation. In the setting of worsening low back pain, failure of trial of nonoperative management, and elevated inflammatory markers, the patient was admitted and found to have urinary tract infection-associated L4-L5 spinal epidural abscess with associated L4-L5 discitis and osteomyelitis. This case report evaluates the clinical history, diagnostic workup, and treatment of urinary tract infection-associated lumbar epidural abscesses.

Conclusion: Epidural abscesses are suppurative collections around the dura with potentially devastating neurologic complications. This report outlines the diagnostic challenges and treatment strategies associated with a urinary tract infection-associated epidural abscess in a middle-aged male with no underlying comorbidities.

Keywords: Spinal epidural abscess; Urinary tract infection; UTI; Lumbar; Spine; Discitis; Osteomyelitis; E. coli