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Primary Spinal Epidural Abscess

Carol J. Baker, MD
Am J Dis Child. 1971;121(4):337-339. doi:10.1001/archpedi.1971.02100150111016.
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Seven cases of primary spinal epidural abscess in children under age 12 have been reported; an additional case in a 2-year-old girl is presented. These infections, usually located in the dorsal epidural space of the mid thoracic or lower lumbar regions, are the result of hematogenous dissemination of bacteria, almost always penicillin-resistant Staphylococcus aureus, from foci of infection in the skin, or respiratory or urinary tracts. Early signs and symptoms are nonspecific, but eventually the patient shows signs of cord compression which vary with the location of the abscess. Laboratory studies suggest infection and the organism is sometimes isolated from blood cultures. Careful lumbar puncture should be done once the diagnosis of epidural abscess is suspected, followed by laminectomy and drainage as well as systemic antibiotics. Prognosis is excellent if surgery is performed before the development of neurologic deficit.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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