Pediatric Group A streptococcal spinal epidural abscess presenting with recurrent symptoms of viral illness: An operative case report

Abstract

Background: Spinal epidural abscess (SEA) in children is a rare condition with dangerous sequelae, and with only 22 other cases reported in the literature, treatment algorithms are poorly understood. Quick identification of the classic tried of sepsis, back pain and neurological deficit is critical. Source identification difficult and often cannot be identified. Reported pathogens include varicella-zoster virus, S. aureus, and S pyogenes. Case description:We report a case of spontaneous pediatric SEA in a 22-month old female without obvious neurologic deficit, who underwent a T10-11 decompressive laminotomy and evacuation of abscess and subsequent 3-week course of intravenous ceftriaxone for culture positive S. pyogenes Outcome: The patient showed marked improvement in symptoms after decompression. 5 weeks postoperatively after transitioning from intravenous ceftriaxone to oral ceftin, the patient redeveloped a deep space infection and was taken back for a repeat debridement. The cultures from this procedure were negative and the patient was discharged on oral clindamycin.Conclusions: Pediatric spontaneous SEA is a rare condition and early diagnosis and surgical intervention if indicated can prevent dangerous sequelae. Further studies into the surgical indications for decompression will aid in algorithmic decision making.

Acute Paraplegia Caused by Spinal Epidural Empyema Following Infectious Cellulitis of the Hand: Case Report and Literature Review

“…Risk factors include diabetes mellitus, intravenous drug use, alcohol consumption, steroids, gout, rheumatoid arthritis, peripheral vascular disease, and renal failure. 37 38 Streptococcus pyogenes , in its invasive form, can have several listed etiologies, notably for cellulitis (39%). 22 Linked to this condition, several microorganisms can be disseminated via hematogenous or lymphatic routes, perpetuating the proliferation of bacteria in unusual places.…”

“…Cellulitis is an inflammatory condition, sometimes of infectious origin, where various tissues are affected, which can lead to pain, swelling and functional loss. Risk factors include diabetes mellitus, intravenous drug use, alcohol consumption, steroids, gout, rheumatoid arthritis, peripheral vascular disease, and renal failure [58]. S. pyogenes, in its invasive form, can have several listed etiologies, This article is protected by copyright.…”