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Child's Nervous System

, Volume 34, Issue 10, pp 1947–1956 | Cite as

Pediatric spinal infections—a review of non-tuberculous infections

  • Chandan B. MohantyEmail author
  • Graham Fieggen
  • Chandrashekhar E. Deopujari
Special Annual Issue

Abstract

Pediatric spinal infection includes spinal epidural abscess, spondylodiscitis and intradural (extramedullary and intramedullary) spinal infections. However, these entities are extremely rare and no clear guidelines exist for their management. Pertinent literature was searched and a detailed narrative review of this topic is presented.

Keywords

Pediatric Spinal infection Abscess Epidural Intradural Subdural Spondylodiscitis Discitis Intramedullary 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Duraiswami PK, Orth M, Tuli SM (1971) 5000 years of orthopaedics in India. Clin Orthop Relat Res 75:269–280CrossRefPubMedGoogle Scholar
  2. 2.
    Deopujari CE, Mohanty CB (2017) Pediatric (nontuberculous) spinal infections. In: Di Rocco C, Pang D, Rutka J (eds) Textbook of pediatric neurosurgery. Springer, ChamGoogle Scholar
  3. 3.
    Martin RJ, Yuan HA (1996) Neurosurgical care of spinal epidural, subdural, and intramedullary abscesses and arachnoiditis. Orthop Clin North Am 27:125–136PubMedGoogle Scholar
  4. 4.
    Auletta JJ, John CC (2001) Spinal epidural abscesses in children: a 15-year experience and review of the literature. Clin Infect Dis 32:9–16CrossRefPubMedGoogle Scholar
  5. 5.
    Rigamonti D, Liem L, Sampath P, Knoller N, Numaguchi Y, Schreibman DL, Sloan MA, Wolf A, Zeidman S (1999) Spinal epidural abscess: contemporary trends in etiology, evaluation, and management. Surg Neurol 52:189–196CrossRefPubMedGoogle Scholar
  6. 6.
    Rubin G, Michowitz SD, Ashkenazi A et al (1993) Spinal epidural abscess in the pediatric age group: case report and review of literature. Pediatr Infect Dis J 12:1007–1011CrossRefPubMedGoogle Scholar
  7. 7.
    Hogan QH (1996) Epidural anatomy examined by cryomicrotome section. Influence of age, vertebral level, and disease. Reg Anesth 21:395–406PubMedGoogle Scholar
  8. 8.
    Tovar-Spinoza Z, Bode M (2011) Spinal epidural abscess in a neonate. J Neurosurg Pediatr 7:205–208CrossRefPubMedGoogle Scholar
  9. 9.
    Sandler AL, Thompson D, Goodrich JT, van Aalst J, Kolatch E, el Khashab M, Nejat F, Cornips E, Mohindra S, Gupta R, Yassari R, Daniels LB, Biswas A, Abbott R (2013) Infections of the spinal subdural space in children: a series of 11 contemporary cases and review of all published reports. A multinational collaborative effort. Childs Nerv Syst 29:105–117CrossRefPubMedGoogle Scholar
  10. 10.
    Candon E, Frerebeau P (1994) Bacterial abscesses of the spinal cord. Review of the literature (73 cases). Rev Neurol (Paris) 150:370–376Google Scholar
  11. 11.
    Curry WT, Hoh BL, Amin-Hanjani S et al (2005) Spinal epidural abscess: clinical presentation, management, and outcome. Surg Neurol 63:364–371CrossRefPubMedGoogle Scholar
  12. 12.
    Dörflinger-Hejlek E, Kirsch E, Reiter H et al (2010) Diffusion-weighted MR imaging of intramedullary spinal cord abscess. AJNR 31:1651–1652CrossRefPubMedGoogle Scholar
  13. 13.
    Bartels RH, de Jong TR, Grotenhuis JA (1992) Spinal subdural abscess. Case report. J Neurosurg 76:307–311CrossRefPubMedGoogle Scholar
  14. 14.
    Vergori A, Cerase A, Migliorini L, Pluchino MG, Oliveri G, Arrigucci U, de Luca A, Montagnani F (2015) Pediatric spinal epidural abscess in an immunocompetent host without risk factors: case report and review of the literature. IDCases 2:109–115CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Siddiq F, Chowfin A, Tight R (2004) Medical vs surgical management of spinal epidural abscess. Arch Intern Med 164:2409–2412CrossRefPubMedGoogle Scholar
  16. 16.
    Chen WC, Wang JL, Wang JT et al (2008) Spinal epidural abscess due to Staphylococcus aureus: clinical manifestations and outcomes. J Microbiol Immunol Infect 41:215–221PubMedGoogle Scholar
  17. 17.
    Hawkins M, Bolton M (2013) Pediatric spinal epidural abscess: a 9-year institutional review and review of the literature. Pediatrics 132(6):e1680–e1685CrossRefPubMedGoogle Scholar
  18. 18.
    Pereira CE, Lynch JC (2005) Spinal epidural abscess: an analysis of 24 cases. Surg Neurol 63(suppl 1):S26–S29CrossRefPubMedGoogle Scholar
  19. 19.
    Quach C, Tapiero B, Noya F (2002) Group A streptococcus spinal epidural abscess during varicella. Pediatrics 109(1):e14CrossRefPubMedGoogle Scholar
  20. 20.
    Schweich PJ, Hurt TL (1992) Spinal epidural abscess in children: two illustrative cases. Pediatr Emerg Care 8(2):84–87CrossRefPubMedGoogle Scholar
  21. 21.
    Darouiche RO, Hamill RJ, Greenberg SB, Weathers SW, Musher DM (1992) Bacterial spinal epidural abscess. Review of 43 cases and literature survey. Medicine (Baltimore) 71(6):369–385CrossRefGoogle Scholar
  22. 22.
    Lener S, Hartmann S, Barbagallo GMV, Certo F, Thomé C, Tschugg A (2018) Management of spinal infection: a review of the literature. Acta Neurochir 160(3):487–496CrossRefPubMedGoogle Scholar
  23. 23.
    Principi N, Esposito S (2016) Infectious discitis and spondylodiscitis in children. Int J Mol Sci 17:1464CrossRefGoogle Scholar
  24. 24.
    Dayer R, Alzahrani MM, Saran N (2018) Spinal infections in children. Bone Joint J 100-B(4):542–548CrossRefPubMedGoogle Scholar
  25. 25.
    Eshaghi H, Norouzi S, Heidari-Bateni G, Mamishi S (2013) Spondylodiscitis: a rare complication of button battery ingestion in a 10-month-old boy. Pediatr Emerg Care 29:368–370CrossRefPubMedGoogle Scholar
  26. 26.
    Young A, Tekes A, Huisman TA et al (2015) Spondylodiscitis associated with button battery ingestion: prompt evaluation with MRI. Neuroradiol J 28:504–507CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Fernandez M, Carrol CL, Baker CJ (2000) Discitis and vertebral osteomyelitis in children: an 18-year review. Pediatrics 105:1299–1304CrossRefPubMedGoogle Scholar
  28. 28.
    Gouliouris T, Aliyu SH, Brown NM (2010) Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother 65(Suppl 3):iii11–iii24PubMedGoogle Scholar
  29. 29.
    Skaf GS, Domloj NT, Fehlings MG, Bouclaous CH, Sabbagh AS, Kanafani ZA, Kanj SS (2010) Pyogenic spondylodiscitis: an overview. J Infect Public Health 3:5–16CrossRefPubMedGoogle Scholar
  30. 30.
    Sobottke R, Seifert H, Fätkenheuer G, Schmidt M, Gossmann A, Eysel P (2008) Current diagnosis and treatment of spondylodiscitis. Dtsch Arztebl Int 105:181–187PubMedPubMedCentralGoogle Scholar
  31. 31.
    Jeong DK, Lee HW, Kwon YM (2015) Clinical value of procalcitonin in patients with spinal infection. J Korean Neurosurg Soc 58(3):271–275CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    De Moraes Barros Fucs PM, Meves R, Yamada HH (2012) Spinal infections in children: a review. Int Orthop 36:387–395CrossRefGoogle Scholar
  33. 33.
    Bidet P, Collin E, Basmaci R, Courroux C, Prisse V, Dufour V, Bingen E, Grimprel E, Bonacorsi S (2013) Investigation of an outbreak of osteoarticular infections caused by Kingella kingae in a childcare center using molecular techniques. Pediatr Infect Dis J 32(5):558–560CrossRefPubMedGoogle Scholar
  34. 34.
    Shah LM, Ross JS (2016) Imaging of degenerative and infectious conditions of the spine. Neurosurgery 79:315–335CrossRefPubMedGoogle Scholar
  35. 35.
    Digby JM, Kersley JB (1979) Pyogenic non-tuberculous spinal infection: an analysis of thirty cases. J Bone Jt Surg Br 61:47–55CrossRefGoogle Scholar
  36. 36.
    Cottle L, Riordan T (2008) Infectious spondylodiscitis. J Inf Secur 56:401–412Google Scholar
  37. 37.
    Kayser R, Mahlfeld K, Greulich M, Grasshoff H (2005) Spondylodiscitis in childhood: results of a long-term study. Spine 30:318–323CrossRefPubMedGoogle Scholar
  38. 38.
    Berbari EF, Kanj SS, Kowalski TJ et al (2015) 2015 Infectious Diseases Society of America (IDSA) clinical practice guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adults. Clin Infect Dis 61:e26–e46CrossRefPubMedGoogle Scholar
  39. 39.
    Dormans JP, Moroz L (2007) Infection and tumors of the spine in children. J Bone Joint Surg Am 89:79–97PubMedGoogle Scholar
  40. 40.
    Milstone AM, Goldner BW, Ross T, Shepard JW, Carroll KC, Perl TM (2011) Methicillin-resistant Staphylococcus aureus colonization and risk of subsequent infection in critically ill children: importance of preventing nosocomial methicillin-resistant Staphylococcus aureus transmission. Clin Infect Dis 53:853–859CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Park KH, Chong YP, Kim SH et al (2013) Clinical characteristics and therapeutic outcomes of hematogenous vertebral osteomyelitis caused by methicillin-resistant Staphylococcus aureus. J Inf Secur 67:556–564Google Scholar
  42. 42.
    Bosilkovski M, Rodriguez-Morales AJ (2014) Brucellosis and its particularities in children travelers. Recent Pat Antiinfect Drug Discov 9:164–172CrossRefPubMedGoogle Scholar
  43. 43.
    Principi N, Esposito S (2015) Kingella kingae infections in children. BMC Infect Dis 15:260CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Hadjipavlou AG, Mader JT, Necessary JT, Muffoletto AJ (2000) Hematogenous pyogenic spinal infections and their surgical management. Spine 25:1668–1679CrossRefPubMedGoogle Scholar
  45. 45.
    Chen WH, Jiang LS, Dai LY (2007) Surgical treatment of pyogenic vertebral osteomyelitis with spinal instrumentation. Eur Spine J 16:1307–1316CrossRefPubMedGoogle Scholar
  46. 46.
    Fu TS, Chen LH, Chen WJ (2013) Minimally invasive percutaneous endoscopic discectomy and drainage for infectious spondylodiscitis. Biom J 36:168–174Google Scholar
  47. 47.
    Schneider P, Givens TG (1998) Spinal subdural abscess in a pediatric patient: a case report and review of the literature. Pediatr Emerg Care 14:22–23CrossRefPubMedGoogle Scholar
  48. 48.
    Heusner AP (1948) Nontuberculous spinal epidural infections. N Engl J Med 239:845–854CrossRefPubMedGoogle Scholar
  49. 49.
    Ahmad F, Pandey P, Sharma B, Garg A (2006) Foot drop after spinal anesthesia in a patient with a low-lying cord. Int J Obstet Anesth 15:233–236CrossRefPubMedGoogle Scholar
  50. 50.
    Hollis PH, Malis LI, Zappulla RA (1986) Neurological deterioration after lumbar puncture below complete spinal subarachnoid block. J Neurosurg 64:253–256CrossRefPubMedGoogle Scholar
  51. 51.
    De Bonis P, Anile C, Pompucci A, Labonia M, Lucantoni C, Mangiola A (2009) Cranial and spinal subdural empyema. Br J Neurosurg 23:335–340CrossRefPubMedGoogle Scholar
  52. 52.
    Naidich TP, Castillo M, Cha S, Raybaud C, Smirniotopoulos JG, Kollias SD (2011) Imaging of the spine. Elsevier, New YorkGoogle Scholar
  53. 53.
    Sorar M, Er U, Seckin H, Ozturk MH, Bavbek M (2008) Spinal subdural abscess: a rare cause of low back pain. J Clin Neurosci 15:292–294CrossRefPubMedGoogle Scholar
  54. 54.
    Morandi X, Mercier P, Fournier H-D, Brassier G (1999) Dermal sinus and intramedullary spinal cord abscess. Report of two cases and review of the literature. Childs Nerv Syst 15:202–207CrossRefPubMedGoogle Scholar
  55. 55.
    Fraser RAR, Ratzan K, Wolpert SM, Weinstein L (1973) Spinal subdural empyema. Arch Neurol 28:235–238CrossRefPubMedGoogle Scholar
  56. 56.
    Tuzun Y, Kadioglu HH, Izci Y, Suma S, Keles M, Aydin IH (2004) The clinical, radiological and surgical aspects of cerebral hydatid cysts in children. Pediatr Neurosurg 40:155–160CrossRefPubMedGoogle Scholar
  57. 57.
    Simon JK, Lazareff JA, Diament MJ et al (2003) Intramedullary abscess of the spinal cord in children: a case report and review of the literature. Pediatr Infect Dis J 22:186–192PubMedGoogle Scholar
  58. 58.
    Al Barbarawi M, Khriesat W, Qudsieh S, Qudsieh H, Loai AA (2009) Management of intramedullary spinal cord abscess: experience with four cases, pathophysiology and outcomes. Eur Spine J 18:710–717CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Chan CT, Gold WL (1998) Intramedullary abscess of the spinal cord in the antibiotic era: clinical features, microbial etiologies, trends in pathogenesis, and outcomes. Clin Infect Dis 27:619–626CrossRefPubMedGoogle Scholar
  60. 60.
    Mohindra S, Gupta R, Chhabra R, Gupta SK, Pathak A, Bal AK, Radotra BD (2008) Infected intraparenchymal dermoids: an underestimated entity. J Child Neurol 23:1011–1016CrossRefPubMedGoogle Scholar
  61. 61.
    Volkan E (2012) Intramedullary spinal cord abscesses in children: a review. J Neurol Sci 28(4):651–661Google Scholar
  62. 62.
    Garg RK (2004) Diagnostic criteria for neurocysticercosis: some modifications are needed for Indian patients. Neurol India 52:171–177PubMedGoogle Scholar
  63. 63.
    Murphy KJ, Brunberg JA, Quint DJ, Kazanjian PH (1998) Spinal cord infection: myelitis and abscess formation. AJNR Am J Neuroradiol 19:341–348PubMedGoogle Scholar
  64. 64.
    Roh JE, Lee SY, Cha SH, Cho BS, Jeon MH, Kang MH (2011) Sequential magnetic resonance imaging finding of intramedullary spinal cord abscess including diffusion weighted image: a case report. Korean J Radiol 12:241–246CrossRefPubMedPubMedCentralGoogle Scholar
  65. 65.
    Maurice-Williams RS, Pamphilon D, Coakham HB (1980) Intramedullary abscess—a rare complication of spinal dysraphism. J Neurol Neurosurg Psychiatry 43:1045–1048CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Vadivelu S, Desai SK, Illner A, Luerssen TG, Jea A (2014) Infected lumbar dermoid cyst mimicking intramedullary spinal cord tumor: observations and outcomes. J Pediatr Neurosci 9:21–26CrossRefPubMedPubMedCentralGoogle Scholar
  67. 67.
    Kurita N, Sakurai Y, Taniguchi M et al (2009) Intramedullary spinal cord abscess treated with antibiotic therapy. Neurol Med Chir 49:262–268CrossRefGoogle Scholar
  68. 68.
    Citow J, Ammirati M (1994) Intramedullary tuberculoma of the spinal cord: case report. Neurosurg 35:327–330CrossRefGoogle Scholar
  69. 69.
    Sharma MC, Arora R, Deol PS, Mahapatra AK, Sinha AK, Sarkar C (2002) Intramedullary tuberculoma of the spinal cord: a series of ten cases. Clin Neurol Neurosurg 104:279–284CrossRefPubMedGoogle Scholar
  70. 70.
    Devi BI, Chandra S, Mongia S, Chandramouli BA, Sastry KV, Shankar SK (2002) Spinal intramedullary tuberculoma and abscess: a rare cause of paraparesis. Neurol India 50:494–496PubMedGoogle Scholar
  71. 71.
    Qi B, Ge P, Yang H, Bi C, Li Y (2011) Spinal intramedullary cysticercosis: a case report and literature review. Int J Med Sci 8:420–423CrossRefPubMedPubMedCentralGoogle Scholar
  72. 72.
    Jung H, Hurtado M, Medina MT, Sanchez M, Sotelo J (1990) Dexamethasone increases plasma levels of albendazole. J Neurol 237:279–280CrossRefPubMedGoogle Scholar
  73. 73.
    Tufan K, Cekinmez M, Sener L, Erdogan B (2008) Infected lumbar dermoid cyst presenting with tetraparesis secondary to holocord central lesion. J Child Neurol 23:934–937CrossRefPubMedGoogle Scholar
  74. 74.
    Hung PC, Wang HS, Wu CT, Lui TN, Wong AM (2007) Spinal intramedullary abscess with an epidermoid secondary to a dermal sinus. Pediatr Neurol 37:144–147CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Chandan B. Mohanty
    • 1
    Email author
  • Graham Fieggen
    • 2
  • Chandrashekhar E. Deopujari
    • 1
  1. 1.Bombay Hospital Institute of Medical SciencesMumbaiIndia
  2. 2.Division of Neurosurgery, Red Cross War memorial Children’s Hospital and Groote Schuur HospitalUniversity of Cape TownCape TownSouth Africa

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