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Journal of Child Neurology
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Holocord Spinal Epidural Abscess

Partha Sekhar Ghosh, MD

Pediatric Hospital Medicine, Cleveland Clinic, Cleveland, Ohioghoshp3{at}ccf.org

Tobias Loddenkemper, MD

Department of Neurology, Cleveland Clinic, Cleveland, Ohio

Manuel Buitrago Blanco, MD, PhD

Department of Neurology, Cleveland Clinic, Cleveland, Ohio

Michelle Marks, DO

Pediatric Hospital Medicine, Cleveland Clinic, Cleveland, Ohio

Camille Sabella, MD

Pediatric Infectious Disease, Cleveland Clinic, Cleveland, Ohio

Debabrata Ghosh, MD

Department of Neurology, Cleveland Clinic, Cleveland, Ohio

Spinal epidural abscess is rare in infants and leads to major permanent neurological deficits if the condition is left untreated. Holocord epidural abscess is extremely rare. We report a patient with methicillin-resistant Staphylococcus aureus septicemia presenting with pneumonia, retroperitoneal abscess, and epidural abscess. A 7-month-old previously healthy girl presented with fever, irritability, tachypnea for 4 days and decreased movement of the right lower limb for 1 day. Magnetic resonance imaging of the spine demonstrated an extensive epidural abscess from second cervical to fifth lumbar vertebrae without osteomyelitis or discitis. The epidural abscess was treated with intravenous antibiotics for 6 weeks. At 3 months follow-up, no neurological deficits were present. Only a few case reports of holocord epidural abscess in children have been published. We present a case of conservatively treated holocord spinal abscess in an infant.

Key Words: holocord spinal epidural abscess • staphylococcus • methicillin-resistant

Journal of Child Neurology, Vol. 24, No. 6, 768-771 (2009)
DOI: 10.1177/0883073808329524
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