A 64-year-old woman presented to the emergency department, agitated and confused with a history of back pain, alcoholic cirrhosis and previous drainage of a neck abscess. She developed clonic-tonic seizures and was referred to intensive care. She was intubated and a lumbar puncture yielded pus with Clostridium difficile grown on culture. MRI scanning revealed an epidural abscess with evidence of discitis. The authors speculate on the origin of the infection and review the presentation of epidural abscess.