| Epidural pneumatosis of the cervicothoracic spine associated with transient upper motor neuron findings complicating Haemophilus influenzae pharyngitis, bronchitis, and mediastinitis. | |
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MedLine Citation:
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PMID: 20574262 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Epidural pneumatosis and pneumomediastinum are rare findings. Reports in children are exceedingly rare. Abnormal neurologic findings have yet to be reported. METHODS: We report on the case of a 7-year-old girl who was diagnosed with epidural pneumatosis with signs of neurologic compression in the setting of Haemophilus influenzae upper and lower respiratory infection. After urgent direct laryngoscopy, bronchoscopy, esophagoscopy, and pharyngeal biopsy was carried out, CT scan of the chest revealed extensive pneumomediastinum tracking along vessels throughout the neck and chest in addition to epidural pneumatosis from C6 to T5. Upper motor neuron findings were present. Broad spectrum antibiotics were administered, and interval neurologic examination and repeat CT scans showed resolution of abnormal neurologic exam in addition to epidural pneumatosis dissipation. RESULTS: Rapid clinical improvement was noted on broad spectrum intravenous antibiotics with extubation on postoperative day one. She was discharged home on oral augmentin on postoperative day 4 with intact neurologic examination. At 11 month follow-up, she remained symptom-free with normal neurologic examination and unremarkable cervical and thoracic spine radiographs. CONCLUSION: Resolution of clinical and radiographic findings is possible with conservative treatment. LEVEL OF EVIDENCE: IV. |
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Authors:
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Christopher C Harrod; Robert E Boykin; Young J Kim |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of pediatric orthopedics Volume: 30 ISSN: 1539-2570 ISO Abbreviation: J Pediatr Orthop Publication Date: 2010 Jul-Aug |
Date Detail:
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Created Date: 2010-06-24 Completed Date: 2010-10-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8109053 Medline TA: J Pediatr Orthop Country: United States |
Other Details:
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Languages: eng Pagination: 455-9 Citation Subset: IM |
Affiliation:
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Orthopaedics, Massachusetts General Hospital, Boston, MA, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Bacterial Agents
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therapeutic use Bronchitis / complications*, diagnosis, drug therapy Bronchoscopy Cervical Vertebrae Child Emphysema / diagnosis, drug therapy, etiology* Epidural Space* Esophagoscopy Female Follow-Up Studies Haemophilus Infections / complications*, diagnosis, drug therapy Haemophilus influenzae / isolation & purification Humans Laryngoscopy / methods Mediastinitis / complications*, diagnosis, drug therapy Motor Neuron Disease / complications*, diagnosis, therapy Pharyngitis / complications*, diagnosis, drug therapy Risk Assessment Spinal Diseases / complications, diagnosis, drug therapy Thoracic Vertebrae Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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