A Rare Case of Primary Spinal Epidural Abscess Caused by Streptococcus mitis in an Immunocompetent Adult With Incidentally Diagnosed Allergic Bronchopulmonary Aspergillosis

Spinal epidural abscess (SEA) is a rare suppurative infection of the epidural space which can mechanically compress the spinal cord. Bacteria gain access to this space by hematogenous spread, direct extension, or direct inoculation into the spinal canal. SEA is almost always associated with risk factors, such as diabetes, human immunodeficiency virus (HIV), trauma, intravenous drug use, or spinal injections. The most commonly implicated organism is Staphylococcus aureus (73%), followed by coagulase-negative Staphylococcus and gram-negative organisms. We present a rare case of an immunocompetent woman with no risk factors found to have a primary spinal epidural abscess which grew Streptococcus mitis . To the best of our knowledge this is only the second such case in literature, with the first one being reported in 1995 in an adult man with hemophilia. Diagnosis is made by magnetic resonance imaging (MRI), and treatment is surgical decompression and antibiotics. Clin Infect Immun. 2019;4(1):12-15 doi: https://doi.org/10.14740/cii74