Paraspinal muscle abscesses in children - A case report and review of the literature

Abstract

Background: Few pediatric cases with myositis and abscesses of the paraspinal muscles have been previously reported.

Case description: We herein report on a 3-year-old patient who developed an epidural abscess in a paraspinal muscle abscess, after a complication of infectious impetigo due to atopic dermatitis. The child improved through the administration of an antibacterial drug. The median age of seven patients with a history of paraspinal muscle inflammation and muscle abscess was 12 years old (3-15-years-old), few of which had underlying diseases, with methicillin-sensitive Staphylococcus aureus being the main causative agent. Although the prognosis was well in many cases following the administration of antibacterial agents, there were also cases in which extensive lesions were found and neurological sequelae remained.

Conclusion: The current case was the youngest case ever reported of a paraspinal muscle abscess. Although pediatric cases are rare, in the episode of a fever of unknown origin and difficulty walking, paraspinal muscle abscesses should be cited as a differential diagnosis and appropriate early diagnostic imaging and treatment should be performed.

Keywords: Abscess; Epidural abscess; Low back pain; Paraspinal muscles.

Figure 1:

Lumbar to pelvic simple MRI images were taken of (a) and (b) on the 6^th day of illness, (c) on the 13^th day of illness, and (d) 1 month after discharge.(a) T2-emphasized image: A hyperintensity of marginalization is observed at 2 cm in the right erector spinae muscle (black circle). (b) Diffusion-weighted image: hyperintensity is observed in the posterior to the spinal canal from L4 vertebral body to the sacral region (white circle), (c) T2-enhanced image: paraspinal muscle abscess (white arrow) and epidural abscess (black triangle) tend to shrink, and (d) T2- emphasized image: it is confirmed that the image has completely disappeared.