Pediatric Spinal Epidural Abscess: Recognition and Management in the Emergency Department

Points & Pearls Excerpt

• Fever, back pain, and neurologic symptoms are the classic triad of a spinal epidural abscess (SEA), but this presentation is seen in <10% of cases.³⁵ Young children may present with variable symptoms such as abdominal pain or failure to bear weight.
• Neurologic deficits are an indicator of severe, progressed disease, but they may not be present in the early stages. Lack of neurologic symptoms does not rule out SEA.
• SEA has a very rapid progression of disease. Patients can progress rapidly from a normal neurologic examination to signs of paralysis within 12 to 48 hours.