Spinal epidural abscess with myelitis and meningitis caused by Streptococcus pneumoniae in a young child

幼儿因肺炎链球菌感染导致脊髓硬膜外脓肿伴脊髓炎和脑膜炎

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Abstract

BACKGROUND: Spinal epidural abscess (SEA) in children is a rare infectious emergency warranting prompt intervention. Predisposing factors include immunosuppression, spinal procedures, and local site infections such as vertebral osteomyelitis and paraspinal abscess. Staphylococcus aureus is the most common isolate. DESIGN: Case report and literature review. FINDINGS: A 2.5-year-old boy with tetraparesis was found to have an SEA in the posterior lumbar epidural space with evidence of meningitis and myelitis on MRI spine in the absence of any local or systemic predisposing factors or spinal procedures. Streptococcus pneumoniae was isolated from the evacuated pus. CONCLUSIONS: Definitive treatment of SEA is a combination of surgical decompression and iv antibiotics. Timely management limits the extent of neurological deficit.

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