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Spinal epidural abscess in children: a case-based review
Pietro Spennato1, Daniela Renedo2,3, Daniele Cascone4
1Department of Neurosurgery, Santobono-Pausilipon Children's Hospital, Naples, Italy. pierospen@gmail.com.
Insights
Pediatric spinal epidural abscess is a rare but serious CNS infection. Prompt treatment is crucial to prevent permanent neurological deficits in children.
Area of Science:
- Neurology
- Pediatric Infectious Diseases
- Neurosurgery
Background:
- Spinal epidural abscess (SEA) is a severe CNS infection in children.
- It is rare but carries a high risk of permanent neurological damage if untreated.
Observation:
- Two pediatric cases of SEA are presented.
- One patient with paraplegia had incomplete motor recovery despite prompt surgery.
- Another patient with fever, neck pain, and torticollis achieved good neurological outcome with early intervention.
Findings:
- Timely diagnosis and surgical decompression are vital for managing pediatric SEA.
- Prolonged antibiotic therapy is a standard component of treatment.
- Neurological deficits and delayed treatment significantly worsen prognosis.
Implications:
- Early recognition and intervention in pediatric SEA can improve patient outcomes.
- Aggressive surgical and antibiotic management is essential.
- Understanding prognostic factors aids in clinical decision-making for pediatric SEA.
Background:
Pediatric spinal epidural abscess is a major suppurative infection of the central nervous system. It is an extremely rare pathology carrying serious risk of permanent neurological sequelae if is not properly treated.
Methods And Results:
All the pertinent literature was analyzed, focused on pediatric cases of spinal epidural abscess and its peculiar features. Two illustrative cases are also presented. The first case is that of a 9-year old girl who took medical attention, when she was already paraplegic. Despite prompt surgical evacuation and good neuroradiological outcome and intensive rehabilitation, motor deficits did not recover after surgery. The second case was that of a 14-year old girl who presented with fever, neck pain, and torticollis. Prompt diagnosis, decompressive surgery, and 6 weeks of antibiotics allowed good neurological outcome.
Conclusions:
The management of spinal epidural abscess includes evacuation of the abscess with decompression of the spinal cord and prolonged antibiotic treatment. The presence of neurological deficit and the delay in the initiation of proper treatment are the two factors that more worsen prognosis.
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