Objective To report a case of spinal epidural abscess complicating epidural analgesia, and to heighten awareness of the condition and the importance of early recognition and treatment.

Case Report A 72-year-old woman underwent adrenalectomy and groin dissection for recurrent malignant melanoma under combined general and epidural anesthesia. On the fourth postoperative day, she developed signs of localized infection at the epidural site and a band of reduced sensation. Further neurological signs developed before the diagnosis was made by magnetic resonance imaging scan. She subsequently underwent emergency laminectomy and drainage of epidural abscess.

Conclusion Delayed diagnosis allowed the development of significant morbidity before neurosurgical intervention and antibiotics were instituted.