Pons Mauricio, Pérez Leila, Juárez Facundo
Hospital Interzonal Especializado Materno Infantil "Don Victorio Tetamanti", Mar del Plata.
Arch Argent Pediatr. 2017 Jun 1;115(3):e146-e149. doi: 10.5546/aap.2017.e146.
Spinal epidural abscess is an uncommon pathology. It has an incidence of one case per 100 000 individuals. An increase is observed due to the raise of risk factors such as diabetes mellitus, spinal abnormalities, tattoos, acupuncture, epidural analgesia, and a greater availability of imaging methods. It is a purulent collection located between the dura and the medullary canal. The most common germs are Staphylococcus aureus and Gram-negative bacteria. Without timely treatment, it evolves to medullary compression and permanent neurological sequelae. An 11-year-old girl was admitted with fever of 48 hs evolution, left lower back pain, antalgic gait with lumbar stiffness. Neurological examination was normal. Blunt blistering lesions were observed on lower limbs. Magnetic resonance imaging showed an image compatible with spinal epidural abscess. The evolutionwas favorable. Treatment consisted of surgical drainage and antibiotics for 6 weeks. From the culture of the material obtained, methidllin-sensitive Staphylococcus aureus was isolated.
脊髓硬膜外脓肿是一种罕见的病症。其发病率为每10万人中有1例。由于糖尿病、脊柱异常、纹身、针灸、硬膜外镇痛等危险因素增加以及成像方法的更多应用，观察到发病率有所上升。它是位于硬脑膜和髓管之间的脓性聚集物。最常见的病菌是金黄色葡萄球菌和革兰氏阴性菌。若不及时治疗，会发展为脊髓压迫和永久性神经后遗症。一名11岁女孩因持续48小时发热、左下腹疼痛、伴有腰部僵硬的止痛步态入院。神经检查正常。下肢观察到钝性水疱性病变。磁共振成像显示与脊髓硬膜外脓肿相符的图像。病情进展良好。治疗包括手术引流和使用抗生素6周。从获取的材料培养物中分离出了对甲氧西林敏感的金黄色葡萄球菌。
