A patient developed fever and severe back pain following a surgery done under spinal anaesthesia. On examination a fluctuant swelling is noted at the site of spinal anesthesia. Non-contrast CT scan of the region showed a hypodense soft tissue mass and a diagnosis of epidural abcess is made. What is the treatment of choice in a case of epidural abscess?

## **Core Concept**
Epidural abscess is a serious medical condition characterized by a collection of pus in the epidural space surrounding the spinal cord. It can result from infection introduced during procedures like spinal anesthesia. Prompt treatment is crucial to prevent neurological damage.

## **Why the Correct Answer is Right**
The treatment of choice for epidural abscess involves urgent surgical intervention to drain the abscess, thereby relieving pressure on the spinal cord and preventing further neurological deterioration. This approach, often combined with antibiotics, addresses both the infectious cause and the mass effect of the abscess.

## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is incorrect because, although antibiotics are an essential part of treating epidural abscess, they are not sufficient alone to manage the condition. The abscess must be drained to relieve pressure on the spinal cord.
- **Option B:** This option is incorrect as it suggests a less invasive approach that might not adequately address the urgent need to relieve pressure on the spinal cord.
- **Option C:** This option might seem plausible but is incorrect because it does not specify the immediate need for surgical drainage.

## **Clinical Pearl / High-Yield Fact**
A key point to remember is that delayed treatment of epidural abscess can lead to irreversible neurological deficits. Therefore, a high index of suspicion and prompt intervention are critical.

## **Correct Answer:** . **D. Surgical drainage**

✓ Correct Answer: A. Immediate surgical evacuation