Article in Japanese

Paraspinal muscle abscess complicated with epidural abscess and intervertebral joint arthritis: A case report

Shintaro SENO¹⁾, Shota ONO¹⁾, Shunsaku KAJI¹⁾

A 12-year-old girl consulted orthopedic surgery with the chief complaint of low back pain. She was prescribed acetaminophen, but did not improve. She revisited her former doctor on the 10th day of illness and a suspected iliopsoas muscle hematoma was diagnosed on magnetic resonance imaging. On the 12th day of illness, she developed a fever of 40°C accompanied by nausea, and was referred to our hospital with suspected meningitis. She complained of severe pain to the right lumbar and hypochondriac area at the time of admission, and had difficulty sitting and walking. Contrast-enhanced computed tomography diagnosed multiple abscesses in the erector spinae muscle at the level of L3-L5. Methicillin-sensitive Staphylococcus aureus was identified in blood cultures and abscess puncture fluid at the time of admission. After hospitalization, she developed an epidural abscess from L4 to the sacrum and intervertebral joint arthritis with synovial thickening at L3-4. She was treated with antibiotic therapy for 4 weeks and improved without sequelae. There are few reports of abscesses in the erector spinae muscle in children. In cases of unexplained fever and lumbago, it is important to distinguish this disease as well, and it is important to start diagnosis and treatment before systemic complications develop.

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1) Department of Pediatrics, Tsuyama Chuo Hospital

Key words	paraspinal muscle abscess, epidural abscess, intervertebral joint arthriti
Received	March 15, 2018
Accepted	June 5, 2018

30 (3)：231─237,2018