Tubercular epidural abscess presenting as acute cauda equina syndrome

Abstract

Tubercular epidural abscess without osseous and pulmonary involvement is an extremely rare scenario. Presentation of the same with cauda equina syndrome is even rarer. We present a case of tubercular epidural abscess in 31-year old male patient. He presented with acute cauda equina syndrome and was shown to have epidural abscess extending from L4-S3 vertebral level without any evidence of vertebral involvement in MRI. The patient did not have pulmonary involvement. The patient made an uneventful recovery following surgical decompression and anti-tubercular chemo- therapy. The diagnosis was confirmed by histo-pathological demonstration of tubercular granuloma in the biopsy specimen.