This is a case of a spinal epidural abscess (SEA) in a 41-year-old male with a history of chronic alcohol abuse, who initially presented with severe diabetic ketoacidosis (DKA). Following stabilization of DKA, the patient developed persistent gram-positive bacteremia, which progressed to an epidural abscess extending from the cervical to the thoracic spine with potential intracranial extension. Despite the complexity of the case, prompt diagnosis via magnetic resonance imaging (MRI) and timely neurosurgical intervention for drainage, combined with targeted antibiotic therapy, led to a favorable outcome.
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