Spinal Epidural Abscess in a Sixteen Years Old Boy
Case report and review of literature
Gut J.1, Cipra A.2, Procházková D.2, Pajerek J.2, Bartoš R.3, Derner M.4, Daumová J.5
Dětské oddělení NsP, Česká Lípa1 primář MUDr. J. Gut Dětská klinika Masarykovy nemocnice, Ústí nad Labem2 primář MUDr. J. Škvor, CSc. Neurochirurgické oddělení Masarykovy nemocnice, Ústí nad Labem3 přednosta doc. MUDr. M. Sameš, CSc. Rentgenologické oddělení Masarykovy nemocnice Ústí nad Labem4 primář MUDr. M. Derner Rentgenologické oddělení NsP Česká Lípa5 primářka MUDr. H. Čerbáková |
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Summary:
Spinal epidural abscess (SEA) is a rare disease especially at the child age. Only tens
of case reports have been published so far. It is certainly a disease of a high degree of
risk for the development of permanent neurological lesion and even the risk of fatal
end.
Classical triad (back pain, febrile conditions, neurological topical deficit) occurs only
in a part of patients and the disease therefore often escapes early recognition for unspecific
symptoms. Themethod of diagnostic examination includes spiral CT orMR of the
spinal region. The degree of the disease is the basis for considering between
a conservative procedure of long-termparenteral therapy with antibiotics or neurosurgical
laminectomy with drainage of the abscess. The prognosis if favorable in early diagnosis
and adequate treatment are applied.
The demonstrated case of a 16-year boy is the first case of SEA at the child age in available
Czech literature. The boy was admitted for a febrile condition, lumbalgia, left side lumbar paravertebral painful contracture and slightly elevated inflammatorymarkers.
For the progression of complaints in spite of ATB administration and for diagnostic
uncertainties, the authors indicated spiral CT examination in the search for spinal
or paraspinal pyogenic affection, which revealed SEA confirmed subsequently by MR.
The patient was treated conservatively without the need of neurosurgery.
Key words:
spinal epidural abscess, laminectomy, intraspinal pyogenic infection,
Staphylococcus aureus
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