Spinal epidural abscess is a rare diagnosis with a classic triad of fever, spinal pain and neurologicdeficits. Only a small proportion of patients have all three findings, making the diagnosis challenging.Here we present a case of cervical and thoracic spinal epidural abscess complicated by meningitis,sepsis and thrombocytopenia in a patient lacking traditional risk factors. The patient was initiallytreated non-operatively secondary to thrombocytopenia but subsequently required transfer to atertiary care facility for surgical drainage after clinical deterioration. This case report highlights theneed for a high index of suspicion and low threshold for imaging when considering this rare butpotentially deadly condition.