[Vertebral osteomyelitis with epidural abscess in a child with sickle cell disease].
A case of paraplegia due to a thoracic epidural abscess in a 6-year-old black girl with sickle cell anemia is reported. MRI and CT scan showed abnormalities involving T6 vertebra which were consistent with osteomyelitis. A laminotomy, associated to antibiotic administration, permitted rapid neurological improvement. Although cultures were negative, the infection was probably due to salmonellae. Salmonellosis is a well-known complication in children with sickle cell disease but spinal localization is unusual. Its pathogenesis is unclear but immunological abnormalities associated to vascular obstructions by abnormal blood red cells have been advocated. The underlying etiology of vertebral abnormalities in these children is difficult to determine, but early diagnosis with modern investigations, as CT scan and MRI, is crucial to promptly begin therapy for osteomyelitis, minimizing the risk of spinal cord compression.
Rivierez
M
M
Service de Neurochirurgie.
Heyman
D
D
Bazin
M
M
D000755:Anemia, Sickle Cell / Q000150:complications* / Q000175:diagnosis; D002648:Child; D020802:Epidural Abscess / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D010019:Osteomyelitis / Q000150:complications* / Q000175:diagnosis; D013122:Spinal Diseases / Q000150:complications* / Q000175:diagnosis