Successful Treatment of Pediatric Holo-Spinal Epidural Abscess With Percutaneous Drainage
By Admin | May 02, 2022
Abstract
Spinal epidural abscess (SEA) is a rare and potentially devastating neurologic disease that is commonly treated with neurosurgical decompression and evacuation. We describe the case of an 11-month-old immunocompetent infant who presented with a large multiloculated methicillin-resistant Staphylococcus aureus abscess in the left lung apex with likely mediastinal involvement, extending into the epidural space from C7 down to L2 causing cord compression which was successfully treated with percutaneous placement of an epidural drainage catheter and antibiotic therapy. Although there are rare reports of percutaneous drainage of SEAs, to our knowledge, there are no reports of successful use of percutaneous indwelling catheters resulting in the complete resolution of an SEA. Holo-spinal epidural abscess in an infant is an extremely rare disease with limited literature available regarding the best practice for its treatment. Multiple considerations must be taken into account when weighing the different treatment options ranging from surgical decompression to conservative management with antibiotic therapy. We present a unique case of successful treatment with percutaneous epidural drain placement. This provides a reasonable alternative for management in children for whom surgical decompression carries multiple risks for complications both acutely and delayed.
Introduction
Spinal epidural abscess (SEA) is a rare but potentially devastating neurologic disease that is commonly treated with neurosurgical decompression and evacuation. The incidence ranges from 0.2 to 1.2 patients per 10,000 hospital admissions, but only a few percent of these cases occur in children, with holocord epidural abscess even rarer with fewer than a dozen cases reported in the literature [1]. Early diagnosis and prompt treatment are critical, with an excellent prognosis if treated in a timely fashion [2]. However, this can be difficult in the pediatric population given the nonspecific signs and symptoms in infants leading to delays in diagnosis [3]. We describe the case of an 11-month-old immunocompetent infant who presented with a holocord posterior spinal epidural methicillin-resistant...(More)
For more info please read, Successful Treatment of Pediatric Holo-Spinal Epidural Abscess With Percutaneous Drainage, by Cureous
