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Pediatria Polska - Polish Journal of Paediatrics
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3/2024
vol. 99
 
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abstract:
Case report

Spinal epidural empyema – an unusual cause of focal back pain in a teenager

Katarzyna Walkowiak
1
,
Arleta Olejniczak
2
,
Paweł Walkowiak
3
,
Joanna Michalczuk
2
,
Izabela Karolczyk
1
,
Krzysztof Zakrzewski
4
,
Krzysztof Zeman
2
,
Marcin Tkaczyk
2

  1. Department of Paediatrics, John Paul II Regional Hospital of Bełchatów, Bełchatów, Poland
  2. Department of Paediatrics, Immunology and Nephrology, Polish Mother’s Memorial Hospital Research Institute of Łódź, Łódź, Poland
  3. Department of Neurology with Stroke Subdivision, John Paul II Regional Hospital of Bełchatów, Bełchatów, Poland
  4. Department of Neurosurgery, Polish Mother’s Memorial Hospital Research Institute of Łódź, Łódź, Poland
Pediatr Pol 2024; 99 (3): 270-274
DOI: https://doi.org/10.5114/polp.2024.143175
Online publish date: 2024/09/23
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A spinal epidural empyema (SEE) is a collection of pus between the bones of the vertebral column and the dura covering the spinal cord. It is an uncommon disease in the pediatric population. It requires prompt diagnosis and targeted treatment to prevent permanent disability. The gold standard of management involves surgical treatment and systemic antibiotic therapy.

We present the clinical case of a 15-year-old boy with focal back pain in the lower thoracic region, causing limitations of spinal mobility, but no neurological dysfunction. Due to the patient’s history, elevated inflammatory parameters and magnetic resonance imaging, epidural empyema was detected. The patient was operated on with the evacuation of pus from epidural space and temporary drainage placement and following administration of intravenous antibiotics. A complete recovery was achieved.

The non-specificity of the SEE symptoms poses a significant challenge for clinicians. Increased vigilance is therefore necessary when diagnosing seemingly benign disorders for a favorable clinical outcome.
keywords:

back pain, pediatrics, spinal epidural abscess, MSSA, spinal epidural empyema