Nontuberculous Spinal Epidural Abscess

Abstract

is uncommon, but the possible success of adequate therapy makes early diagnosis critical. The symptoms usually follow a rather regular pattern. The purpose of this paper is to report a case, to review the literature, and to recall to pediatricians the existence of this entity. At the present time approximately 275 cases of nontuberculous spinal epidural abscess are recorded in the literature. Many of these have been in older children and adolescents, but only a very few, perhaps no more than a dozen, have occurred in children younger than 5 years of age. The youngest recorded case we know of is that of Campbell's,1 in a 1 -y e a r -o l d girl. Bailey and Love 2 mention a case occurring at the age of 1 week but give no details of the case.The mother stated that she had noticed that the child had not used the left arm since birth, but she had never thought it was paralyzed or ab¬ normal. Apparently the infant had been well until a few days prior to admission when he lost his appetite and refused his bottle. The day before admission he had vomited every feeding, and this vomiting was projectile.Past medical history disclosed that the baby was a full-term infant born on Jan. 21, 1954. The mother's course during pregnancy was marked by vaginal bleeding in the third month that necessi¬ tated bed rest for 2 weeks. Subsequent prenatal course was uneventful, and delivery ensued after a 23-hour labor with a prolonged second stage. Out¬ let forceps were used, and the baby was born from a left occipitoanterior position which had rotated from a left occipitotransverse position. The mother was Rh positive, with no history of abortions, and had one living child.At birth the infant's condition was described as good, the weight being 8 lb. 6 oz. (about 3,799 gm.).His progress in the nursery was uneventful ; he was circumcised on Jan. 25, 1954, and discharged from Downloaded From: http://archpedi.jamanetwork.com/ by a University of Iowa User on 06/01/2015

Iatrogenic Vitamin B Deficiency

“…The site of these perforations on the anterior rectal wall just above the peritoneal reflection corresponds with the site of perforation in cases reported following barium enema (Hartman & Hills 1957) and in perforations of the rectum by a thermometer (Segnitz 1957, Warwick & Gikas 1959, Miller 1962, Canby 1963). I suspect that in these two cases perforation of the rectum was produced by a thermometer and was not spontaneous, as considered at operation.…”