Beyond Enteric Infections: A Case of Salmonella Spinal Epidural Abscess-Case Report.

Spinal epidural abscess (SEA) is a serious but rare condition that is often challenging to diagnose early due to atypical presentations, especially in patients without common risk factors such as immunosuppression or sickle cell disease. This case report describes a 49-year-old woman with a history of alcohol use disorder who presented with flank pain and other nonspecific symptoms, initially misdiagnosed as musculoskeletal pain. MRI eventually revealed a SEA caused by nontyphoidal Salmonella (NTS), requiring surgical intervention and antibiotics. The discussion highlights the difficulty of diagnosing SEA, especially in patients without classic risk factors, emphasizing the need for high clinical suspicion, thorough history-taking, and timely use of MRI. Prompt imaging, neurosurgical consultation, and antibiotic administration are critical for effective management and favorable outcomes. Strategies for improving early diagnosis include using decision guides for emergent MRI and repeat imaging if initial results are nondiagnostic. This article aims to provide clinicians with an overview of SEA caused by NTS, emphasizing the importance of maintaining a high index of suspicion, critically examining reported risk factors, and exploring potential approaches for earlier diagnosis.