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Spinal epidural abscess treated with antibiotics alone.
Ashish Pathak1, Poonam Singh, Prateek Gehlot
1Department of Pediatrics, RD Gardi Medical College, Ujjain, Madhya Pradesh, India. drashishp@rediffmail.com
BMJ Case Reports
|May 2, 2013
Summary
A pediatric spinal epidural abscess (SEA) case in India showed complete recovery with antibiotics alone. This rare clinical stage 4 recovery highlights potential non-surgical treatment options for pediatric SEA.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neurosurgery
Background:
- Spinal epidural abscess (SEA) is uncommon in children, often lacking typical symptoms.
- Early diagnosis and prompt treatment are crucial for favorable outcomes in pediatric SEA.
Observation:
- A 13-year-old boy presented with paraparesis and autonomic dysfunction (bladder/bowel involvement).
- MRI revealed a C7-D1 spinal epidural abscess with significant cord and minimal vertebral marrow edema.
Findings:
- The patient received exclusive antibiotic treatment (ceftriaxone and vancomycin).
- Complete neurological recovery was observed after 6 weeks, with only minor residual gait disturbance.
- This represents the first reported pediatric clinical stage 4 SEA recovery with antibiotics alone from India.
Implications:
- Antibiotic monotherapy may be a viable treatment for select pediatric SEA cases, even at advanced stages.
- Close neurological monitoring is essential to detect any signs of deterioration requiring surgical intervention.
- This case expands treatment possibilities for pediatric spinal epidural abscesses, emphasizing tailored therapeutic approaches.
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