Spinal epidural abscess. An infectious emergency. Case report and review
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Pediatric spinal epidural abscess, often caused by Staphylococcus aureus, needs rapid diagnosis and surgical drainage for good outcomes. Early symptoms like back pain and fever can precede severe neurological decline.
Area of Science:
- Pediatric infectious diseases
- Neurosurgery
- Radiology
Background:
- Spinal epidural abscess (SEA) is rare in children.
- Prompt diagnosis and surgical intervention are crucial for favorable outcomes.
Observation:
- Common presenting symptoms include back pain and fever.
- Neurologic deterioration can be rapid.
- Staphylococcus aureus is the most frequent causative agent, often spread hematogenously.
Findings:
- Computed tomography (CT) aids diagnosis.
- Myelography or magnetic resonance imaging (MRI) is essential to detect skip lesions throughout the entire spine.
Implications:
- Early recognition and management of pediatric SEA can prevent long-term neurological deficits.
- Comprehensive spinal imaging is vital for complete assessment and treatment planning.
Abstract:
Spinal epidural abscess is an unusual disease in the pediatric age group, requires early diagnosis and prompt surgical drainage to insure a good clinical outcome. Back pain and fever are usually the only presenting symptoms occurring before precipitous neurologic deterioration. The causative organism is most often Staphylococcus aureus, which presumably is spread to the epidural space hematogenously. Diagnosis is facilitated by computed tomography (CT) scan, but the entire spine must be imaged by either myelography or magnetic resonance imaging (MRI) to assess for skip lesions.