Spontaneous spinal epidural abscess in a 21-month-old child

Spontaneous epidural abscess formation is a rare finding in all populations and even more so in the pediatric population. Its rarity and varied presentations often lead to misdiagnosis. We present a pediatric case in which the diagnosis of spontaneous spinal epidural abscess was missed upon initial...

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Bibliographic Details
Published in:The American journal of emergency medicine 2014-12, Vol.32 (12), p.1558.e1-1558.e2
Main Authors: Harris, Tyler J., MD, Seamon, Jason P., DO, MHS
Format: Article
Language:English
Subjects:
Children & youth
Ear diseases
Emergency
Emergency medical care
Epidural Abscess - diagnosis
Fever
Humans
Infant
Magnetic Resonance Imaging
Male
Medical treatment
NMR
Nuclear magnetic resonance
Pediatrics
Population
Spinal Cord Diseases - diagnosis
Streptococcal Infections - diagnosis
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Summary:Spontaneous epidural abscess formation is a rare finding in all populations and even more so in the pediatric population. Its rarity and varied presentations often lead to misdiagnosis. We present a pediatric case in which the diagnosis of spontaneous spinal epidural abscess was missed upon initial presentation and subsequently identified at a later visit to the emergency department. Literature suggests utilizing three simple physical exam findings that may improve the first visit diagnosis of spontaneous epidural abscesses in children. Findings of any two of the following signs should guide the clinician to consider SEA as a possibility prior to discharge: fever, back or neck pain, extremity weakness or inability to walk.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2014.05.029