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PEDIATRICS Vol. 106 No. 3 September 2000, p. e39

ELECTRONIC ARTICLE:
Spinal Epidural Abscess in a Young Child

Received Nov 15, 1999; accepted Mar 13, 2000.

Megan H. Bair-Merritt*, Charles ChungDagger , and Albert Collier§

From the * University of North Carolina School of Medicine; and the Departments of Dagger  Pediatric Radiology and § Pediatric Infectious Disease, University of North Carolina Children's Hospital, Chapel Hill, North Carolina.

This is a case report of a spinal epidural abscess, caused by Staphylococcus aureus, in a 3-year-old girl. The child presented with fever and hip pain, but without any neurologic deficit. After normal plain films and a normal bone scan were obtained, the diagnosis was made via magnetic resonance imaging (MRI). The neurosurgery and pediatric infectious disease teams evaluated the patient, and the decision was made to forgo surgical drainage and to treat medically with appropriate intravenous and then oral antibiotics. Several months later, the child was doing well without any signs of neurologic sequelae. Because of the rarity of this disease in children, the treatment guidelines are controversial. Many suggest that a spinal epidural abscess must be drained surgically. Our experience adds to the literature a case of a child successfully treated with antibiotics alone. We believe that this success is related to the fact that the child was diagnosed by MRI early in the course of the disease and that she never displayed any neurologic deficits.

 Key words:  spinal epidural abscess, magnetic resonance imaging, antibiotic treatment, child.