Spontaneous spinal epidural abscess in a neonate - With a review of the literature

Spinal epidural abscess is uncommon in neonates and infants, and is usually related to previous lumbar puncture or epidural anaesthesia. Diagnosis is often delayed because of the non-specific presentation. We present a 7-week -old girl who developed paraplegia 3 weeks after transient fever and a self -limiting skin rash. MR imaging revealed an epidural contrast-enhancing les ion compressing the spinal cord. At operation, an organised granulated absc ess was identified with Staphylococcus aureus the causative organism. Lamin ectomy and removal of the organised abscess and systemic intravenous antibi otics resulted in complete neurological recovery. The patient did not devel op late spinal deformity following the decompressive laminectomy. The rapid onset of paraplegia can often be missed in such a young child but should b e promptly investigated, as surgical treatment of cord compression carries an excellent prognosis for neurological recovery. We review the literature on the initial presentation, usual investigations, causative organisms and surgical management of paediatric spinal epidural abscesses.