Lee Inn-Chi, Quek Yeak-Wun, Tsao Shih-Ming, Chang I-Chang, Sheu Ji-Nan, Chen Jia-Yuh
Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.
J Child Neurol. 2010 Oct;25(10):1284-7. doi: 10.1177/0883073809357938. Epub 2010 Feb 5.
Spinal abscess is rare in children, especially in young infants. The most common etiology is bacteria, Staphylococcus aureus in particular. Mycobacterium tuberculosis is another cause. We report an unusual cervical spinal abscess with spinal cord compression in a 13-month-old child. The presenting symptoms were weakness in the right arm and, predominantly, the right leg for 1 month. Magnetic resonance imaging showed an abscess of the cervical spine, extension with bony destruction, and spinal cord compression. The patient underwent an emergency neurosurgical decompression and laminectomy. Pathology and culture results confirmed Mycobacterium tuberculosis. After 12 months of antituberculosis treatment, the child could walk with a walker. At 37 months, he was able to walk without assistance. We conclude that spinal tuberculosis should be considered in cases of children with spinal cord-compression symptoms and an image showing an extraspinal abscess. Early diagnosis and prompt treatment are critical for maximizing a functional recovery.
脊髓脓肿在儿童中罕见，尤其是在幼儿中。最常见的病因是细菌，特别是金黄色葡萄球菌。结核分枝杆菌是另一个病因。我们报告了一例13个月大儿童发生的不寻常的颈椎脊髓脓肿并伴有脊髓受压。主要症状为右臂无力，主要是右腿无力，持续1个月。磁共振成像显示颈椎脓肿，伴有骨质破坏和脊髓受压。患者接受了急诊神经外科减压和椎板切除术。病理和培养结果证实为结核分枝杆菌。经过12个月的抗结核治疗，患儿能够借助助行器行走。在37个月时，他能够独立行走。我们得出结论，对于出现脊髓受压症状且影像学显示椎旁脓肿的儿童病例，应考虑脊髓结核。早期诊断和及时治疗对于最大限度地实现功能恢复至关重要。
