A case of spinal epidural abscess, cauda equina syndrome, retroperitoneal abscess, aortic graft infection and aortoenteric fistula.

Low back pain is a common complaint in those presenting to the emergency department (ED), but only a small fraction of patients will have an emergent pathology. Specific features such as immunocompromised status, injection drug use, preexisting infection, fever, urinary or fecal retention or incontinence, perineal sensory changes, or lower extremity weakness should prompt the emergency physician to consider emergent pathology. We discuss the case of a 61-year-old male with extensive past medical history including thoracoabdominal aneurysm repair, aortoenteric fistula with chronic infection, and severe lumbar neural foraminal narrowing who presented with complaints of low back pain, fecal incontinence, and motor weakness of the left lower extremity. Subsequent magnetic resonance imaging and computed tomography scan demonstrated multiple pathologies including spinal epidural abscess, cauda equina syndrome, retroperitoneal abscess, and aortic graft infection with aortoenteric fistula, conditions associated with significant morbidity and mortality.