Mycobacterium bovis spinal epidural abscess in a 6-year-old boy with leukemia

Spinal epidural abscess (SEA) is an uncommon and often serious infection in childhood. Rapid diagnosis with early surgical and medical treatment is extremely important to prevent permanent neurologic sequelae. Diagnosing SEA in pediatric patients can be difficult due to the infrequent occurrence, inadequate verbalization of symptoms, and variability of presentation.1-3 The most common cause of SEA is Staphylococcus aureus but other Gram-positive cocci, Gram-negative rods, and anaerobes have been reported.1 Tuberculous SEA has been described in adults and children, but it almost invariably occurs with osteomyelitis of the surrounding bony structures (Pott's disease).4,5 The only known pediatric case of SEA caused by Mycobacterium bovis (presented in brief as part of a large series of M bovis infections in San Diego)6 is presented here.