The Pediatric infectious disease journal · 2026
Spinal Epidural Abscess in Children With Anatomical Anomalies of the Spine: Case Series and Literature Review.
СтатьяОбзорКлинический случайНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Regev Asaf, Pratt Li-Tal, Roth Jonathan, Constantini Shlomi, Klivitzky Amir, Grisaru-Soen Galia
Аннотация
BACKGROUND: Spinal epidural abscess (SEA) is a rare pathology with potentially devastating consequences if not treated expeditiously.
METHODS: We retrospectively analyzed clinical and laboratory data retrieved from the medical records of children (age <18 years) admitted to a tertiary pediatric hospital with a diagnosis of SEA and available imaging findings of spinal dysraphism (SD) between 1/2010 and 8/2024.
RESULTS: Eight children diagnosed with SD or other anatomical spinal anomaly prior or at the presentation of an SEA were included. The most common clinical presentation was fever (n = 8). Dermal sinus (n = 4) was the most common physical finding. The clinical diagnosis of SEA was made with a mean of 27 days after symptom onset. Escherichia coli and Enterococcus faecalis were the most cultured pathogens. The diagnosis of SEA was made by magnetic resonance imaging in all cases. All 8 children were treated with systemic antibiotics and all had undergone surgical interventions. Four patients remained with a neurologic sequelae, most commonly neurogenic bladder (n = 4).
CONCLUSIONS: Our report is the first case series of SEA due to SD in a pediatric population described to date. Children with SD are at increased risk for SEA and usually develop this complication at a younger age compared to those with SEA without anatomical risk factors. They are also at increased risk for delayed diagnosis, concomitant meningeal involvement and long-term neurologic sequelae. The most significant variables influencing outcome are timely diagnosis and surgical intervention, followed by appropriate antibiotic administration.
METHODS: We retrospectively analyzed clinical and laboratory data retrieved from the medical records of children (age <18 years) admitted to a tertiary pediatric hospital with a diagnosis of SEA and available imaging findings of spinal dysraphism (SD) between 1/2010 and 8/2024.
RESULTS: Eight children diagnosed with SD or other anatomical spinal anomaly prior or at the presentation of an SEA were included. The most common clinical presentation was fever (n = 8). Dermal sinus (n = 4) was the most common physical finding. The clinical diagnosis of SEA was made with a mean of 27 days after symptom onset. Escherichia coli and Enterococcus faecalis were the most cultured pathogens. The diagnosis of SEA was made by magnetic resonance imaging in all cases. All 8 children were treated with systemic antibiotics and all had undergone surgical interventions. Four patients remained with a neurologic sequelae, most commonly neurogenic bladder (n = 4).
CONCLUSIONS: Our report is the first case series of SEA due to SD in a pediatric population described to date. Children with SD are at increased risk for SEA and usually develop this complication at a younger age compared to those with SEA without anatomical risk factors. They are also at increased risk for delayed diagnosis, concomitant meningeal involvement and long-term neurologic sequelae. The most significant variables influencing outcome are timely diagnosis and surgical intervention, followed by appropriate antibiotic administration.