Pediatric intracranial epidural abscess secondary to an infected scalp vein catheter.
The authors present a case of a 5-week-old infant developing a retrotorcular epidural abscess as a result of an infected scalp vein catheter. The abscess developed in the absence of sinusitis, otitis, trauma, or prior surgery. The diagnosis of epidural abscess was made on the basis of magnetic resonance imaging and ultrasound-guided aspiration of the fluid collection. An identified strain of Staphylococcus epidermidis was cultured from both the intravenous catheter and the abscess. The patient underwent a suboccipital craniectomy with drainage of the abscess and a 6-week total course of intravenous antibiotics. Magnetic resonance imaging 4 months after the procedure and 2.5-year pediatric clinic follow-up have demonstrated no evidence of neurologic deficit or recurrence. When present, a scalp vein catheter must be considered as an etiologic agent for an intracranial epidural abscess in this age-group.
Lefkowitz
M A
MA
Division of Endovascular Therapy, Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif., USA. mlefkowitz@ucla.edu
Chin
L S
LS
Couldwell
W T
WT
D001922:Brain Abscess / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000382:microbiology; D004824:Epidural Space; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007262:Infusions, Intravenous / Q000009:adverse effects* / Q000295:instrumentation; D001239:Inhalation; D008279:Magnetic Resonance Imaging; D008297:Male; D012535:Scalp / Q000098:blood supply*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D013212:Staphylococcus epidermidis / Q000302:isolation & purification*