Turkish Neurosurgery 2019 , Vol 29 , Num 5
A Case Report of a 4-Year-Old Boy with Intradural Spinal Cord Abscess Successfully Treated with Adjuvant Hyperbaric Oxygen Therapy
Ayse SAHIN1,Mustafa KILIC2,Nazan DALGIC1
1University of Health Sciences, Sisli Hamidiye Etfal Research and Education Hospital, Pediatric Infectious Diseases Clinic, Istanbul, Turkey
2University of Health Sciences, Sisli Hamidiye Etfal Research and Education Hospital, Neurosurgery Clinic, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.22971-18.2 Intradural spinal cord abscesses are rare infections in early childhood and usually result from pre-existing congenital anomalies of the spinal column. The formation of abscess may be the result of hematogenous spread. It is treated by surgical and parenteral antibiotic treatment, but some special cases may require additional treatments. This article presents a 4-year-old male patient who was previously operated on for spina bifida (meningocele and tethered cord syndrome) at another hospital. Upon complaints of not being able to walk after one month, he was operated on with the diagnosis of spinal intradural abscess and referred to our clinic to continue his treatment. The patient underwent an emergency operation when his new spinal magnetic resonance imaging (MRI) at our hospital showed progression of intradural abscess. Due to no regression of neurological deficits in the follow-up and the risk of another operation, antimicrobial treatment as well as hyperbaric oxygen therapy (HBOT) was planned. At the end of 20 HBOT treatment sessions, the patient started to walk with support and the antibiotic treatment was completed in six weeks. In cases where surgical and antimicrobial treatments have failed, HBOT should be considered as an additional treatment method in children with spinal abscess. Keywords : Abscess, Child, Hyperbaric oxygen therapy, Spinal cord
Corresponding author : Ayse SAHIN, ayseturgutsahin@gmail.com