Spinal epidural abscess in a 1-month-old child.
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Osteomyelitis of the odontoid process is a rare disease and Staphylococcus aureus is the usual causative organism. We present a case caused by a synergistic infection with Staphylococcus aureus and Proteus mirabilis, which has not been reported previously. A high index of suspicion is required for diagnosis, and early institution of broad antimicrobial therapy, including agents active against gram-negative organisms, is mandatory.
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A 57-year-old black female burned in a house fire sustained 22.5% total body surface area burns. On postburn day 45, she developed Staphylococcus aureus septicemia, and vancomycin was begun. On postburn day 50, quadriplegia developed. Magnetic resonance imaging revealed an anterior cervical mass, and cervical drainage of a staphylococcal cervical abscess was conducted. Antibiotics were continued. The patient regained almost complete neurologic function and was discharged doing well.
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