Spinal Intradural Escherichia coli Abscess Masquerading as a Neoplasm in a Pediatric Patient with History of Neonatal E. coli Meningitis: A Case Report and Literature Review

BACKGROUND: Central nervous system abscesses frequently can be seen in the immunocompromised population and most commonly consist of intracranial collections in the adult patient. Spinal intradural abscesses are less commonly encountered, and there are even fewer numbers in the pediatric population with a concordant absence of documentation in the published literature. CASE DESCRIPTION: In this case report, we describe the presentation of a 2-year-old boy with a history of perinatal Escherichia coli meningitis at 2.5 months of age who was found to have an intradural spinal lesion, initially concerning for neoplasm, but later confirmed as an E. coli abscess following biopsy. He was managed with surgical aspiration of the abscess and a long course of intravenous antibiotics. The patient was treated with antibiotics with repeat imaging studies that revealed residual abscess that required re-aspiration at a later date. CONCLUSIONS: Here we present an unusual disease process with an unusual disease pathogenesis in a pediatric patient currently residing in a developed country.