Cauda equina syndrome is caused by compression or injury to the nerve roots distal to the level of the spinal cord. This syndrome presents as low back pain, motor and sensory deficits in the lower extremities, and bladder as well as bowel dysfunction. Acute cauda equina syndrome presenting in an immunocompetent patient is usually due to a prolapse of the intervertebral disc. Although various etiologies of cauda equina syndrome have been reported, a less common cause is infection.
Case presentation: A 35-year-old male patient presented with weakness of both lower limbs with loss of bladder and bowel control for three day. He had a history of pain in the lower back since one month. The extensors and flexors of the toes on both sides had Medical Research Council (MRC) grade of 3/5 power. Sensations were decreased below the S1 dermatome on both sides with perianal anesthesia and the ankle jerk was absent on both sides. A clinical diagnosis of cauda equina syndrome was made.
Conclusion: Cauda equina syndrome, presenting as a result of spinal infection, such as the case reported here, is extremely rare but clinically important. Surgical intervention is generally the recommended therapeutic modality with good functional outcome.