Journal
JOURNAL OF CLINICAL MEDICINE
Volume 11, Issue 15, Pages -Publisher
MDPI
DOI: 10.3390/jcm11154549
Keywords
intramedullary spinal cord abscess; ISCA; abscess; spinal cord tumor; antibiotics; dermal sinus; epidermoid cyst; dermoid cyst
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Funding
- stat funds of the Department of Neurosurgery, Spine and Peripheral Nerves Surgery of Medical University of Lodz, Lod
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Intramedullary spinal cord abscesses (ISCA) are rare and mainly affect children under 6 years old. Typical symptoms include infection signs, motor deficits, and sensory deficits. Common pathogens include Staphylococcus aureus and Mycobacterium tuberculosis. The prognosis for children is generally good, with most patients achieving complete neurological recovery.
Intramedullary spinal cord abscesses (ISCA) are rare. Typical symptoms include signs of infection and neurological deficits. Symptoms among (younger) children can be highly uncharacteristic. Therefore, prompt and proper diagnoses may be difficult. Typical therapeutic options include antibiotics and neurosurgical exploration and drainage. In this review, we analyze published cases of ISCA among children. Most pediatric cases were found to be under the age of 6 years. The typical symptoms included motor deficits in 89.06%, infection signs in 85.94%, and sensory deficits in 39.06%. Urinary dysfunction was observed in 43.75%, and bowel dysfunction in 17.19%. The predisposing factors included dermal sinuses, (epi)dermoid cysts, prior infection, iatrogenic disorder, and trauma. The most common pathogens were: Staphylococcus aureus, Mycobacterium tuberculosis, Escherichia coli, and Proteus mirabilis. The pediatric population has good outcomes as 45.93% of patients had complete neurological recovery and only 26.56% had residual neurological deficits. Fifteen (23.44%) had persistent neurological deficits. Only one (1.56%) patient died with an ISCA. In two (3.13%) cases, there were no details about follow-up examinations.
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