Spinal Epidural Abscess in Children

Abstract

This is a report of three children with spinal epidural abscess. The literature is reviewed and the features of this condition in children are noted. Because of the nonspecificity of presenting symptoms in children, the diagnosis may be delayed, resulting in a worse outcome, especially in children under 1 year of age. The extensive laminectomy advised for the treatment of spinal epidural abscesses in adults is undesirable in children because of the risk of spinal deformity and in most cases is probably not necessary.

Pediatric Spinal Epidural Abscess: A 9-Year Institutional Review and Review of the Literature

“…4,11,13,16,17 Untreated disease has variable progression, especially in young children. 14,15 Acute-phase reactants (CRP and ESR) can provide insight into the level of inflammation and tissue involvement. 3,18 ESR has been shown to be a strong indicator of disease, more so than leukocyte count.…”

MR imaging of spinal epidural sepsis

“…The neurologic deficit is less likely to be reversible the more severe and the longer it has been present. Thus, many authors have recognized that prompt and early diagnosis is critical to the management of this potentially curable disease [1][2][3][4][5][6][7][8][9][10][11][12][13]. We recently encountered four patients with spinal epidural infections (three pyogenic, one tuberculous) in whom MR imaging of the spine led to expeditious treatment and better clinical outcome.…”

Pan Spinal Epidural Abscess in a Young Healthy Male: A Case Report

“…An epidural hematoma caused by epidural analgesic injections or trauma (injury or surgery) may later become the focus of bacterial colonization by hematogenous dissemination from a cutaneous or mucosal source, or infection can occur from direct seeding from the invasive procedure itself [5][6][7]. Epidural abscess may also result from the direct spread of infection into the epidural space from a source adjacent to the spine such as spondylodiscitis, paraspinal abscess, or vertebral osteomyelitis [7,12].…”

“…Epidural abscess may also result from the direct spread of infection into the epidural space from a source adjacent to the spine such as spondylodiscitis, paraspinal abscess, or vertebral osteomyelitis [7,12]. Systemic illness, such as diabetes mellitus, immune deficiency states, such as AIDS or cancer, renal failure, IV drug abuse, and steroid therapy contribute to this process [1][2][3][4][5][6][7][8]. SEA in young healthy patients without any risk factors is extremely rare.…”

“…Many SEA patients have a direct source of infection such as epidural injections or spinal injury [1][2][3][4][5][6][7]. Conditions that are usually associated with SEA include diabetes mellitus, cancer, AIDS, IV drug abuse, alcoholism, steroid treatment, chronic renal failure, herpes zoster, and reflex sympathetic dystrophy [1-3, 8, 9].…”