Pediatric spinal epidural abscess in an immunocompetent host without risk factors: Case report and review of the literature

IDCases
Alessandra VergoriFrancesca Montagnani

Abstract

Spinal epidural abscesses (SEAs) are unusual bacterial infections, with possible devastating neurologic sequelae. Despite abundance of case series in adults, reports in children are scanty. We describe a spontaneous SEA due to methicillin susceptible Staphylococcus aureus (MSSA) in a previously healthy 15-year old male, and we perform a literature review regarding management of pediatric SEAs without risk factors, from 2001 to 2014. We found a total of 12 cases (8 males, average age 9.6 years). Clinical presentation was mainly fever, back pain and elevation of inflammation markers. All cases were initially misdiagnosed. Lumbar puncture was performed in 36% of patients. Etiological diagnosis was obtained in 8 cases. MSSA was isolated in 4 patients, methicillin-resistant S. aureus in 1 patient, and S. aureus with unknown susceptibility patterns in 2 cases. The average of therapy duration was 6 weeks. Patients' spine was always evaluated by gadolinium-enhanced magnetic resonance imaging; most abscesses were localized at thoracic and lumbar area, without osteomyelitis. In 8 cases, laminectomy and/or abscess drainage were performed in association with medical therapy; 3 cases were successfully treated with antimicrobial therapy only...Continue Reading

References

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Citations

Apr 3, 2020·Pediatrics in Review·Theresa A ElderMary D Moore
Jul 5, 2018·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Chandan B MohantyChandrashekhar E Deopujari
Apr 16, 2020·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Pietro SpennatoGiuseppe Cinalli
Feb 23, 2019·Journal of Paediatrics and Child Health·Matthew P O'BrienChristopher C Blyth
Feb 25, 2019·World Neurosurgery·Rebecca HoustonCatherine A Mazzola

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