Abscesso epidural espinhal na adolescência: relato de caso
Spinal epidural abscess (SEA) is a rare infectious emergency and capable of causing severe neurological deficits, especially in childhood. The mortality rate in adults varies from 5 to 23%, but in children the rates are even lower. This report aims to contribute to the scientific field by discussing...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Pediatria
2023-06-01
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| Series: | Residência Pediátrica |
| Subjects: | |
| Online Access: | https://residenciapediatrica.com.br/detalhes/1320/abscesso%20epidural%20espinhal%20na%20adolescencia-%20relato%20de%20caso |
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| author | Aléxia Alves Cabral Cecília Pereira Silva Amanda Freire de Almeida Christian Candido Ferreira Ricardo Kalil Laviola Gabriel Kalil Laviola Oliveira e Silva |
| author_facet | Aléxia Alves Cabral Cecília Pereira Silva Amanda Freire de Almeida Christian Candido Ferreira Ricardo Kalil Laviola Gabriel Kalil Laviola Oliveira e Silva |
| author_sort | Aléxia Alves Cabral |
| collection | DOAJ |
| description | Spinal epidural abscess (SEA) is a rare infectious emergency and capable of causing severe neurological deficits, especially in childhood. The mortality rate in adults varies from 5 to 23%, but in children the rates are even lower. This report aims to contribute to the scientific field by discussing a case of SEA in pediatrics. It is a teenager, 17 years old, presenting fever, low back pain and sebaceous cyst infected on her back for three days. She reports a history of drainage two days ago and a cesarean section with spinal anesthesia a year ago. Magnetic resonance imaging (MRI) of the lumbar showed posterior L1-L4 epidural collection. Epidural abscess drainage surgery was performed, with L3-L4 laminectomy, and positive culture for Methicillin-resistant Staphylococcus aureus (MRSA), sensitive to Vancomycin and Rifampicin. She was discharged after 21 days of intravenous Vancomycin, with a prescription for oral Rifampicin for three weeks. Previous skin infection is considered a classic precedent of SEA, suggesting that the patients condition was preceded by furunculosis. The microorganism responsible for 86% of SEA cases in childhood is Staphylococcus aureus. Back pain after spinal anesthesia, fever, skin infection and possible condition of immunosuppression indicated investigation for SEA. Gadolinium-contrast MRI corresponds to the gold standard diagnostic approach for SEA. The suspicion of the disease in pediatrics is extremely important in front of fever, back pain and spinal sensitivity, and should receive due attention and investigation before an indicative clinic. |
| first_indexed | 2024-03-09T16:07:34Z |
| format | Article |
| id | doaj.art-be12ad096be54f659a7b72fc112f2db1 |
| institution | Directory Open Access Journal |
| issn | 2236-6814 |
| language | English |
| last_indexed | 2024-03-09T16:07:34Z |
| publishDate | 2023-06-01 |
| publisher | Sociedade Brasileira de Pediatria |
| record_format | Article |
| series | Residência Pediátrica |
| spelling | doaj.art-be12ad096be54f659a7b72fc112f2db12023-11-24T16:32:09ZengSociedade Brasileira de PediatriaResidência Pediátrica2236-68142023-06-0113210.25060/residpediatr-2023.v13n2-512Abscesso epidural espinhal na adolescência: relato de casoAléxia Alves Cabral0Cecília Pereira Silva1Amanda Freire de Almeida2Christian Candido Ferreira3Ricardo Kalil Laviola4Gabriel Kalil Laviola Oliveira e Silva5Centro Universitário de Volta Redonda, Curso de Medicina - Volta Redonda - Rio de Janeiro - BrasilHospital Santa Cecília, Pediatria - Volta Redonda - Rio de Janeiro - BrasilHospital Santa Cecília, Pediatria - Volta Redonda - Rio de Janeiro - BrasilHospital Santa Cecília, Neurocirurgia - Volta Redonda - Rio de Janeiro - BrasilHospital Santa Cecília, RADIOVIDA - Volta Redonda - Rio de Janeiro - BrasilHospital Santa Cecília, RADIOVIDA - Volta Redonda - Rio de Janeiro - BrasilSpinal epidural abscess (SEA) is a rare infectious emergency and capable of causing severe neurological deficits, especially in childhood. The mortality rate in adults varies from 5 to 23%, but in children the rates are even lower. This report aims to contribute to the scientific field by discussing a case of SEA in pediatrics. It is a teenager, 17 years old, presenting fever, low back pain and sebaceous cyst infected on her back for three days. She reports a history of drainage two days ago and a cesarean section with spinal anesthesia a year ago. Magnetic resonance imaging (MRI) of the lumbar showed posterior L1-L4 epidural collection. Epidural abscess drainage surgery was performed, with L3-L4 laminectomy, and positive culture for Methicillin-resistant Staphylococcus aureus (MRSA), sensitive to Vancomycin and Rifampicin. She was discharged after 21 days of intravenous Vancomycin, with a prescription for oral Rifampicin for three weeks. Previous skin infection is considered a classic precedent of SEA, suggesting that the patients condition was preceded by furunculosis. The microorganism responsible for 86% of SEA cases in childhood is Staphylococcus aureus. Back pain after spinal anesthesia, fever, skin infection and possible condition of immunosuppression indicated investigation for SEA. Gadolinium-contrast MRI corresponds to the gold standard diagnostic approach for SEA. The suspicion of the disease in pediatrics is extremely important in front of fever, back pain and spinal sensitivity, and should receive due attention and investigation before an indicative clinic.https://residenciapediatrica.com.br/detalhes/1320/abscesso%20epidural%20espinhal%20na%20adolescencia-%20relato%20de%20casoepidural abscessanesthesiaspinaladolescent |
| spellingShingle | Aléxia Alves Cabral Cecília Pereira Silva Amanda Freire de Almeida Christian Candido Ferreira Ricardo Kalil Laviola Gabriel Kalil Laviola Oliveira e Silva Abscesso epidural espinhal na adolescência: relato de caso Residência Pediátrica epidural abscess anesthesia spinal adolescent |
| title | Abscesso epidural espinhal na adolescência: relato de caso |
| title_full | Abscesso epidural espinhal na adolescência: relato de caso |
| title_fullStr | Abscesso epidural espinhal na adolescência: relato de caso |
| title_full_unstemmed | Abscesso epidural espinhal na adolescência: relato de caso |
| title_short | Abscesso epidural espinhal na adolescência: relato de caso |
| title_sort | abscesso epidural espinhal na adolescencia relato de caso |
| topic | epidural abscess anesthesia spinal adolescent |
| url | https://residenciapediatrica.com.br/detalhes/1320/abscesso%20epidural%20espinhal%20na%20adolescencia-%20relato%20de%20caso |
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