title: Paediatric tubercular spinal abscess involving the dorsal, lumbar and sacral regions and causing spinal cord compression.
abstract: Tubercular spinal localization is very rare (5%) in paediatric age. We report the unusual case of a child with a history of bacillus Calmette-Guerin vaccination who presented with lymphadenitis in the absence of pulmonary involvement. Despite appropriate anti-tubercular therapy, the patient developed spinal tuberculosis with cord compression. Urgent surgical decompression was performed: laminectomy was done at D3-D5 levels and the higher abscess was then flushed using a catheter, decompressing the cauda equina. Our findings suggest that diagnosis of tuberculosis should be considered even in light of anamnestic vaccination at birth, and that surgical treatment should be rapidly provided in the event of spinal cord compression to avoid devastating sequelae.
authors.affiliation: Department of Pediatric, Pediatric and Infectious Diseases Unit, Bambino Gesu Childrens Hospital, IRCCS, Rome; Department of Internal Medicine, University of Pavia, Pavia; Department of Radiology, Bambino Gesu Childrens Hospital, IRCCS, Rome, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Bozzola
authors.forename: Mauro
authors.initials: M
authors.lastname: Bozzola
authors.forename: Andrea
authors.initials: A
authors.lastname: Magistrelli
authors.forename: Valeria
authors.initials: V
authors.lastname: Calcaterra
authors.forename: Daniela
authors.initials: D
authors.lastname: Larizza
authors.forename: Laura
authors.initials: L
authors.lastname: Lancella
authors.forename: Alberto
authors.initials: A
authors.lastname: Villani
mesh_terms: D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D020802:Epidural Abscess / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D007796:Laminectomy; D008161:Lumbosacral Region / Q000473:pathology / Q000601:surgery; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011718:Pyrazinamide / Q000627:therapeutic use; D035583:Rare Diseases; D012293:Rifampin / Q000627:therapeutic use; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014374:Tuberculin Test; D014399:Tuberculosis, Spinal / Q000150:complications*
chemical_list: D000995:Antitubercular Agents; D011718:Pyrazinamide; D007538:Isoniazid; D012293:Rifampin