Spinal epidural abscesses in children: A 15-year experience and review of the literature

We reviewed medical records and laboratory and diagnostic evaluations for 8 pediatric patients with spinal epidural abscesses who were treated during the last 15 years at our institution. Staphylococcus aureus was isolated fr om 5 of 8 epidural abscesses, including 2 abscesses with methicillin-resist ant S. aureus. Unusual isolates were group B Streptococcus in a patient wit h chronic vesicouretral reflux associated with the posterior urethral valve s and Aspergillus flavus in a patient with acute myelogenous leukemia. An a nalysis incorporating our results and a review of the English-language lite rature about abscesses in children and adults revealed differences related to age. Abscesses in children were more posterior in epidural location, had greater spinal column extension, and were associated with more favorable c linical outcomes than were abscesses in adults. Magnetic resonance imaging is the diagnostic procedure of choice; however, radionuclide bone scans sho uld be considered for associated distant osteomyelitis in children. Prompt diagnosis and combined medical and surgical treatment remain the cornerston es for the prevention of adverse outcomes.