Korean J Pediatr Infect Dis.  2001 May;8(1):107-113. 10.14776/kjpid.2001.8.1.107.

Acute Spinal Epidural Abscess Presenting with Abdominal Pain in a Child

• Jeong EY
• Lee YK
• Kim SH
• Kong BG
• Kim KW
• Park YS
• Kim DW

• KMID: 2440211
• DOI: http://doi.org/10.14776/kjpid.2001.8.1.107

Abstract

Spinal epidural abscess(SEA) is a rare condition in children. Classic symptoms are spinal ache, root pain, weakness and paralysis. The earliest symptoms of SEA in the pediatric age group are nonspecific and variable. Early diagnosis may be almost impossible when local spinal pain is inconspicuous or absent, when toxic epiphenomena divert attention from subtle signs of neurologic dysfunction and when the patient is an acutely distressed and uncooperative child. Failure to diagnosis and treat condition on a timely basis may lead to permanent neurolgic dysfunction or even death. This infection, usually located in the dorsal epidural space of the mid thoracic or lower lumbar regions, is the result of hematogenous dissemination of bacteria, usually Staphylococci, from foci of infection in the skin, or respiratory or urinary tracts. MRI was the diagnostic method of choice. A combination of antibiotics and surgical drainage remains the treatment of choice. Prognosis is excellent if surgery is performed before the development of neurologic deficit. We report a case of SEA in a child whose first presenting symptom was abdominal pain rather than spinal pain. A case is diagnosed by MRI and successfully treated with laminectomy and drainage and antibiotics.

Keyword

Spinal epidural abscess; Child; Early diagnosis; MRI; Laminectomy

MeSH Terms

Abdominal Pain*
Anti-Bacterial Agents
Bacteria
Child*
Diagnosis
Drainage
Early Diagnosis
Epidural Abscess*
Epidural Space
Humans
Laminectomy
Lumbosacral Region
Magnetic Resonance Imaging
Methods
Neurologic Manifestations
Paralysis
Prognosis
Skin
Urinary Tract
Anti-Bacterial Agents