The presence of one or more of the following can be used to diagnose spinal abscess without meningitis:
(1) micro-organisms cultured from an abscess in the spinal epidural or subdural space
(2) identification of an epidural or subdural abscess during surgery
(3) identification of an epidural or subdural abscess during a histopathologic exam
(4) all of the following:
(4a) one or more of the following signs and symptoms:
(4a1) fever > 38°C
(4a2) back pain
(4a3) focal tenderness
(4a4) radiculitis
(4a5) paraparesis
(4a6) paraplegia
(4b) one or both of the following
(4b1) micro-organisms cultured from blood (positive blood culture)
(4b2) radiographic evidence of a spinal abscess
(4c) absence of other explanation
(4d) if diagnosed antemortem then the physician starts appropriate antimicrobial therapy
where:
• Radiographic evidence of infection may include a positive readiolabel scan (gallium, technetium, other), CT scan, MRI or routine X-rays.
