[Primary spinal epidural abscess - a case report]

ABSTRACT

Spinal epidural abscess is a rare affection in child. Bacteria gain access to the epidural space through contiguous spread or hematogenous dissemination. It is more common in thoracolumbar than cervical areas. The organisms most frequently encountered are Staphylococcus aureus. Back pain, fever and neurologic deficit are the three most common symptoms. MRI is the imaging method of choice in diagnosing spinal epidural abscess. Surgical drainage with systemic antibiotics is the treatment of choice. We report the case of a 8 years old children, without any pathological antecedent, hospitalized in the service of Pediatrics for back pain, fever and lameness. The clinical examination found a lumbar rachis painful to the palpation with limited mobility, there was no neurologic deficit. Laboratory investigations showed that inflammatory markers were uniformly elevated. MRI showed a spinal epidural abscess in L3-L4. No micro-organism was isolated in blood cultures. A diagnosis of spinal epidural abscess was suspected and a medical treatment was indicated for 3 months. The outcome was favorable. On the light of this observation, the authors make a review of literature