Spinal tuberculosis in an infant with cord compression

Abstract

Spinal infection is rare in children, especially in young infants. The most common etiology is bacteria; Staphylococcus aureus in particular. Mycobacterium tuberculosis is another rare cause. We report an unusual dorsal spinal abscess with spinal cord compression in a 20-month-old infant. The presenting symptoms were weakness in the inferior limbs, gait disturbance and dorsal deformation for 3 mo. Neurological examination showed a spastic paraparesis and hypoesthesia. Magnetic resonance imaging showed a destruction of fourth vertebral body with anterior extension to posterior mediastinum and spinal cord compression. The patient underwent an emergency neurosurgical decompression by minimal posterior approach laminectomy and removal of tuberculosis granuloma. Histological examination confirms M. tuberculosis. After 9 mo of antituberculosis treatment, the girl could walk without assistance. We conclude that spinal tuberculosis should be considered in cases of children and infants with cord-compression. Early diagnosis and prompt treatment are critical for maximizing a functional recovery.

Keywords

Infant - tuberculosis - cord compression - MRI - surgery