Hyperbaric oxygen therapy (HBO) for the treatment of an epidural abscess in the posterior fossa in an 8-month-old infant

Epidural abscesses in children are extremely rare, especially in the posterior fossa. In some cases antibiotic therapy and surgical drainage are insufficient for complete healing. We present the case of an 8-month-old boy who developed an epidural abscess in the posterior fossa after repeated surgical procedures for retrocerebellar arachnoid cysts and hydrocephalus. We decided to use adjuvant hyperbaric oxygen therapy (HBO) to avoid removal of the bone and the existing ventriculoperitoneal shunt. In this way osteomyelitis, potentially leading to bone removal and shunt infection, could be prevented. HBO is a relatively safe, noninvasive and cost-effective therapy to improve healing of chronic and deep-seated wound infections. To our knowledge HBO has never been used before in such a young child in neurosurgery. Multidisciplinary management is recommended to optimize treatment.