Spinal epidural abscess in a young child

This is a case report of a spinal epidural abscess, caused by Staphylococcu s aureus, in a 3-year-old girl. The child presented with fever and hip pain , but without any neurologic deficit. After normal plain films and a normal bone scan were obtained, the diagnosis was made via magnetic resonance ima ging (MRI). The neurosurgery and pediatric infectious disease teams evaluat ed the patient, and the decision was made to forgo surgical drainage and to treat medically with appropriate intravenous and then oral antibiotics. Se veral months later, the child was doing well without any signs of neurologi c sequelae. Because of the rarity of this disease in children, the treatmen t guidelines are controversial. Many suggest that a spinal epidural abscess must be drained surgically. Our experience adds to the literature a case o f a child successfully treated with antibiotics alone. We believe that this success is related to the fact that the child was diagnosed by MRI early i n the course of the disease and that she never displayed any neurologic def icits.