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.
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Duraiswami PK, Orth M, Tuli SM (1971) 5000 years of orthopaedics in India. Clin Orthop Relat Res 75:269–280
Deopujari CE, Mohanty CB (2017) Pediatric (nontuberculous) spinal infections. In: Di Rocco C, Pang D, Rutka J (eds) Textbook of pediatric neurosurgery. Springer, Cham
Martin RJ, Yuan HA (1996) Neurosurgical care of spinal epidural, subdural, and intramedullary abscesses and arachnoiditis. Orthop Clin North Am 27:125–136
Auletta JJ, John CC (2001) Spinal epidural abscesses in children: a 15-year experience and review of the literature. Clin Infect Dis 32:9–16
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 52:189–196
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 12:1007–1011
Hogan QH (1996) Epidural anatomy examined by cryomicrotome section. Influence of age, vertebral level, and disease. Reg Anesth 21:395–406
Tovar-Spinoza Z, Bode M (2011) Spinal epidural abscess in a neonate. J Neurosurg Pediatr 7:205–208
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 29:105–117
Candon E, Frerebeau P (1994) Bacterial abscesses of the spinal cord. Review of the literature (73 cases). Rev Neurol (Paris) 150:370–376
Curry WT, Hoh BL, Amin-Hanjani S et al (2005) Spinal epidural abscess: clinical presentation, management, and outcome. Surg Neurol 63:364–371
Dörflinger-Hejlek E, Kirsch E, Reiter H et al (2010) Diffusion-weighted MR imaging of intramedullary spinal cord abscess. AJNR 31:1651–1652
Bartels RH, de Jong TR, Grotenhuis JA (1992) Spinal subdural abscess. Case report. J Neurosurg 76:307–311
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 2:109–115
Siddiq F, Chowfin A, Tight R (2004) Medical vs surgical management of spinal epidural abscess. Arch Intern Med 164:2409–2412
Chen WC, Wang JL, Wang JT et al (2008) Spinal epidural abscess due to Staphylococcus aureus: clinical manifestations and outcomes. J Microbiol Immunol Infect 41:215–221
Hawkins M, Bolton M (2013) Pediatric spinal epidural abscess: a 9-year institutional review and review of the literature. Pediatrics 132(6):e1680–e1685
Pereira CE, Lynch JC (2005) Spinal epidural abscess: an analysis of 24 cases. Surg Neurol 63(suppl 1):S26–S29
Quach C, Tapiero B, Noya F (2002) Group A streptococcus spinal epidural abscess during varicella. Pediatrics 109(1):e14
Schweich PJ, Hurt TL (1992) Spinal epidural abscess in children: two illustrative cases. Pediatr Emerg Care 8(2):84–87
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):369–385
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):487–496
Principi N, Esposito S (2016) Infectious discitis and spondylodiscitis in children. Int J Mol Sci 17:1464
Dayer R, Alzahrani MM, Saran N (2018) Spinal infections in children. Bone Joint J 100-B(4):542–548
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 29:368–370
Young A, Tekes A, Huisman TA et al (2015) Spondylodiscitis associated with button battery ingestion: prompt evaluation with MRI. Neuroradiol J 28:504–507
Fernandez M, Carrol CL, Baker CJ (2000) Discitis and vertebral osteomyelitis in children: an 18-year review. Pediatrics 105:1299–1304
Gouliouris T, Aliyu SH, Brown NM (2010) Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother 65(Suppl 3):iii11–iii24
Skaf GS, Domloj NT, Fehlings MG, Bouclaous CH, Sabbagh AS, Kanafani ZA, Kanj SS (2010) Pyogenic spondylodiscitis: an overview. J Infect Public Health 3:5–16
Sobottke R, Seifert H, Fätkenheuer G, Schmidt M, Gossmann A, Eysel P (2008) Current diagnosis and treatment of spondylodiscitis. Dtsch Arztebl Int 105:181–187
Jeong DK, Lee HW, Kwon YM (2015) Clinical value of procalcitonin in patients with spinal infection. J Korean Neurosurg Soc 58(3):271–275
De Moraes Barros Fucs PM, Meves R, Yamada HH (2012) Spinal infections in children: a review. Int Orthop 36:387–395
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):558–560
Shah LM, Ross JS (2016) Imaging of degenerative and infectious conditions of the spine. Neurosurgery 79:315–335
Digby JM, Kersley JB (1979) Pyogenic non-tuberculous spinal infection: an analysis of thirty cases. J Bone Jt Surg Br 61:47–55
Cottle L, Riordan T (2008) Infectious spondylodiscitis. J Inf Secur 56:401–412
Kayser R, Mahlfeld K, Greulich M, Grasshoff H (2005) Spondylodiscitis in childhood: results of a long-term study. Spine 30:318–323
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–e46
Dormans JP, Moroz L (2007) Infection and tumors of the spine in children. J Bone Joint Surg Am 89:79–97
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 53:853–859
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 67:556–564
Bosilkovski M, Rodriguez-Morales AJ (2014) Brucellosis and its particularities in children travelers. Recent Pat Antiinfect Drug Discov 9:164–172
Principi N, Esposito S (2015) Kingella kingae infections in children. BMC Infect Dis 15:260
Hadjipavlou AG, Mader JT, Necessary JT, Muffoletto AJ (2000) Hematogenous pyogenic spinal infections and their surgical management. Spine 25:1668–1679
Chen WH, Jiang LS, Dai LY (2007) Surgical treatment of pyogenic vertebral osteomyelitis with spinal instrumentation. Eur Spine J 16:1307–1316
Fu TS, Chen LH, Chen WJ (2013) Minimally invasive percutaneous endoscopic discectomy and drainage for infectious spondylodiscitis. Biom J 36:168–174
Schneider P, Givens TG (1998) Spinal subdural abscess in a pediatric patient: a case report and review of the literature. Pediatr Emerg Care 14:22–23
Heusner AP (1948) Nontuberculous spinal epidural infections. N Engl J Med 239:845–854
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 15:233–236
Hollis PH, Malis LI, Zappulla RA (1986) Neurological deterioration after lumbar puncture below complete spinal subarachnoid block. J Neurosurg 64:253–256
De Bonis P, Anile C, Pompucci A, Labonia M, Lucantoni C, Mangiola A (2009) Cranial and spinal subdural empyema. Br J Neurosurg 23:335–340
Naidich TP, Castillo M, Cha S, Raybaud C, Smirniotopoulos JG, Kollias SD (2011) Imaging of the spine. Elsevier, New York
Sorar M, Er U, Seckin H, Ozturk MH, Bavbek M (2008) Spinal subdural abscess: a rare cause of low back pain. J Clin Neurosci 15:292–294
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 15:202–207
Fraser RAR, Ratzan K, Wolpert SM, Weinstein L (1973) Spinal subdural empyema. Arch Neurol 28:235–238
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 40:155–160
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 22:186–192
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 18:710–717
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 27:619–626
Mohindra S, Gupta R, Chhabra R, Gupta SK, Pathak A, Bal AK, Radotra BD (2008) Infected intraparenchymal dermoids: an underestimated entity. J Child Neurol 23:1011–1016
Volkan E (2012) Intramedullary spinal cord abscesses in children: a review. J Neurol Sci 28(4):651–661
Garg RK (2004) Diagnostic criteria for neurocysticercosis: some modifications are needed for Indian patients. Neurol India 52:171–177
Murphy KJ, Brunberg JA, Quint DJ, Kazanjian PH (1998) Spinal cord infection: myelitis and abscess formation. AJNR Am J Neuroradiol 19:341–348
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 12:241–246
Maurice-Williams RS, Pamphilon D, Coakham HB (1980) Intramedullary abscess—a rare complication of spinal dysraphism. J Neurol Neurosurg Psychiatry 43:1045–1048
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 9:21–26
Kurita N, Sakurai Y, Taniguchi M et al (2009) Intramedullary spinal cord abscess treated with antibiotic therapy. Neurol Med Chir 49:262–268
Citow J, Ammirati M (1994) Intramedullary tuberculoma of the spinal cord: case report. Neurosurg 35:327–330
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 104:279–284
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 50:494–496
Qi B, Ge P, Yang H, Bi C, Li Y (2011) Spinal intramedullary cysticercosis: a case report and literature review. Int J Med Sci 8:420–423
Jung H, Hurtado M, Medina MT, Sanchez M, Sotelo J (1990) Dexamethasone increases plasma levels of albendazole. J Neurol 237:279–280
Tufan K, Cekinmez M, Sener L, Erdogan B (2008) Infected lumbar dermoid cyst presenting with tetraparesis secondary to holocord central lesion. J Child Neurol 23:934–937
Hung PC, Wang HS, Wu CT, Lui TN, Wong AM (2007) Spinal intramedullary abscess with an epidermoid secondary to a dermal sinus. Pediatr Neurol 37:144–147
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Mohanty, C.B., Fieggen, G. & Deopujari, C.E. Pediatric spinal infections—a review of non-tuberculous infections. Childs Nerv Syst 34, 1947–1956 (2018). https://doi.org/10.1007/s00381-018-3885-8
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DOI: https://doi.org/10.1007/s00381-018-3885-8