Rare Gram-Negative Spinal Epidural Abscess Due to Klebsiella pneumoniae Bacteremia: A Case Report

Spinal epidural abscesses (SEA) are rare but potentially devastating infections with high morbidity and mortality. Most often, a SEA is caused by Staphylococcus aureus and, on rare occasions, by Gram-negative bacteria such as Klebsiella pneumoniae. The incidence of SEA appears to be rising due to increased spinal instrumentation and enhanced detection with magnetic resonance imaging (MRI). In this case report, we discuss a case of a 74-year-old male patient with K. pneumoniae bacteremia secondary to a urinary tract source, complicated by lumbar SEA, L4-L5 osteomyelitis, and vertebral fracture requiring urgent decompression. The patient was successfully treated with surgical drainage and six weeks of intravenous ceftriaxone. This case highlights the importance of maintaining a high index of suspicion for rare causative organisms of SEA in patients presenting with systemic infection and back pain.