Paraspinal abscess in a neonate without epidural extension-a rare entity often misdiagnosed

Background: Paraspinal abscess during the neonatal period is extremely uncommon. Few case reports have been reported in the age group 3-12 years. Case Presentation: A neonate had presented with progressive paraspinal swelling. Radiological Investigations suggested it to be either a cystic lymphangioma or Meningomyelocele. However Clinical findings and lab reports strongly suggested an inflammatory lesion. Management and outcome: in view of strong clinical suspicion, an Incision and drainage of the abscess was done. It revealed frank pus which was sent for culture and sensitivity. Patient was put on I.V. antibiotics and responded well to treatment. Conclusion: Paraspinal abscess should be considered as a differential diagnosis in a neonate presenting with spinal swelling with signs of inflammation. Over reliance on radiological investigations superseding clinical examination can prove detrimental.