METHODS: A 10-year-old child was admitted to pediatrics for investigation of a prolonged fever. The child presented with back pain associated with left hip lameness. An MRI of the spine showed an epidural collection extending from the 4th to the 10th dorsal vertebrae. This collection compressed the spinal cord. An MRI of the left hip showed an appearance consistent with septic arthritis. A left hip arthrotomy was performed, with laminectomy and drainage of the epidural abscess at D7. The patient was treated with antibiotics. The clinical and biological evolution was favorable.
UNASSIGNED: Epidural abscess is a rare but serious infection, now more easily diagnosed by MRI. It is most often caused by hematogenous spread, mainly by Staphylococcus aureus. Symptoms include back pain, neurological signs and fever. Diagnosis is confirmed by MRI. Early diagnosis is essential to prevent neurological complications and death, as the disease can progress to paralysis. Treatment consists of intravenous antibiotics and surgical intervention as indicated.
CONCLUSIONS: Early diagnosis of spinal epidural abscess is important to prevent neurological complications, sepsis and even death. It should be noted that there are no official recommendations or guidelines for the management of epidural spinal abscesses in the pediatric population.
方法:一名10岁儿童因长期发热而入院儿科。患儿出现与左髋关节跛行相关的背痛。脊柱的MRI显示硬膜外集合从第4背侧椎骨延伸到第10背侧椎骨。这个集合压缩了脊髓。左髋关节的MRI显示与化脓性关节炎一致的外观。进行了左髋关节切开术,在D7处椎板切除术和硬膜外脓肿引流。患者接受抗生素治疗。临床和生物进化是有利的。
■硬膜外脓肿是一种罕见但严重的感染,现在更容易通过MRI诊断。它通常是由血行传播引起的,主要由金黄色葡萄球菌。症状包括背痛,神经系统症状和发烧。MRI确诊。早期诊断对于预防神经系统并发症和死亡至关重要,因为这种疾病会进展到瘫痪。治疗包括静脉注射抗生素和手术干预。
结论:脊髓硬膜外脓肿的早期诊断对预防神经系统并发症很重要。败血症甚至死亡.应该指出的是,对于儿科人群中硬膜外脊柱脓肿的管理,没有官方建议或指南。