Presacral neuroenteric fistula in a newborn presenting with an epidural abscess: case report and review of the literature.
We describe a newborn infant (<24 hours of age) who presented with mild swelling on the back and buttocks attributable to a neuroenteric fistula complicated by an epidural parasacral abscess infected with mixed coliforms. Epidural abscesses in infancy are extremely rare, and one has not been observed previously in the newborn period. The infant was surprisingly mildly affected. Prompt intervention led to an excellent outcome. Coliforms may colonize the infant gut in <24 hours, even in the developed world. Unexplained swellings on the backs of infants should lead to a search for underlying malformations and an early surgical review, which is best conducted with a combined pediatric surgical and neurosurgical approach.
Department of Neurosurgery, Wellington School of Medicine and Health Sciences, PO Box 7343, Wellington, New Zealand.
Balsam
B
Darwish
Thorsten V
TV
Stanley
Agadha
A
Wickremesekera
Brendon
B
Bowkett
Mark
M
Leadbitter
D016983:Enterococcus; D020802:Epidural Abscess / Q000209:etiology*; D004927:Escherichia coli Infections / Q000209:etiology; D016908:Gram-Positive Bacterial Infections / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D012003:Rectal Fistula / Q000150:complications / Q000175:diagnosis*; D013118:Spinal Cord Diseases / Q000150:complications / Q000175:diagnosis*