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Paraspinal Abscess in a Two-year-old Female
Rachel O'Donnell1, Sean Sayani1, Phillip Aguìñiga-Navarrete1
1Kern Medical Center, Department of Emergency Medicine, Bakersfield, California.
Insights
Paraspinal abscesses are rare and often diagnosed late. This case highlights successful, rapid treatment of a pediatric lumbar paraspinal abscess via ultrasound-guided drainage.
Area of Science:
- Pediatric Infectious Diseases
- Spinal Surgery
- Diagnostic Imaging
Background:
- Paraspinal abscesses are uncommon, often presenting with vague symptoms leading to delayed diagnosis and increased patient morbidity.
- Risk factors include invasive spinal procedures, diabetes, trauma, steroid use, malnutrition, IV drug use, and immunocompromise.
- Pediatric paraspinal abscesses are particularly underreported in medical literature.
Observation:
- A two-year-old female presented with fever, lower back pain, and reduced oral intake.
- Initial symptoms were nonspecific, delaying definitive diagnosis.
- The patient was ultimately diagnosed with an isolated lumbar paraspinal abscess.
Findings:
- The pediatric patient's isolated lumbar paraspinal abscess was successfully treated with ultrasound-guided percutaneous drainage.
- The patient showed significant clinical improvement post-procedure.
- Hospital discharge occurred within 48 hours of admission.
Implications:
- This case underscores the importance of considering paraspinal abscesses in pediatric patients with relevant symptoms.
- Ultrasound-guided percutaneous drainage offers a minimally invasive and effective treatment option.
- Prompt diagnosis and intervention can significantly reduce morbidity and mortality associated with paraspinal abscesses.
Abstract:
A paraspinal abscess is an uncommon condition frequently diagnosed late due to equivocal symptoms, which can lead to increased morbidity and mortality. Commonly associated risk factors include prior invasive spinal procedures, diabetes mellitus, trauma, chronic steroid use, malnutrition, intravenous drug use and an immunocompromised state. Pediatric paraspinal abscesses are not well documented in the literature. We report a case of a two-year-old female presenting with fevers, lower back pain, and decreased oral intake ultimately diagnosed with isolated lumbar paraspinal abscess. The patient underwent an ultrasound-guided percutaneous drainage of the abscess, subsequently improving, and was discharged within 48 hours of presentation.
