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Pediatric spinal epidural abscess: recognition and management in the emergency department

Bahareh Ravandi1, Christine Cho2

  • 1Clinical Assistant Professor of Pediatrics, Keck School of Medicine, University of Southern California, Children's Hospital Los Angeles, Los Angeles, CA.

Pediatric Emergency Medicine Practice
|May 25, 2022
PubMed

Insights

Spinal epidural abscess (SEA) in children is rare but can cause severe, permanent nerve damage if not diagnosed and treated promptly. Early recognition through specific signs and symptoms is crucial for timely intervention.

Area of Science:

  • Pediatric neurology
  • Infectious diseases
  • Neurosurgery

Background:

  • Spinal epidural abscess (SEA) is a rare but serious condition in children.
  • Delayed diagnosis is common due to nonspecific symptoms and rarity.
  • Untreated SEA can lead to irreversible neurological deficits.

Purpose of the Study:

  • To review key historical and physical examination findings for SEA in children.
  • To provide guidance on appropriate diagnostic tests for suspected SEA.
  • To discuss evidence-based treatment options for pediatric SEA.

Main Methods:

  • Review of clinical presentation, diagnostic criteria, and treatment strategies for pediatric SEA.
  • Analysis of historical and physical examination findings associated with SEA.
  • Evaluation of laboratory and imaging studies for SEA diagnosis.
  • Synthesis of current evidence on SEA management.

Main Results:

  • Highlights specific historical and physical examination clues suggestive of SEA.
  • Recommends timely laboratory and imaging studies (e.g., MRI) for diagnosis.
  • Outlines treatment approaches including antibiotics and surgical decompression.

Conclusions:

  • A high index of suspicion is essential for early diagnosis of pediatric SEA.
  • Prompt diagnosis and treatment are critical to prevent severe neurological complications.
  • Multidisciplinary approach involving pediatricians, neurologists, and surgeons optimizes outcomes.

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