Literature review and a case report of spontaneous subscapular abscess in a child

Subscapular space is an uncommon site for abscess formation. There are only seven reports of subscapular abscesses in the literature. Only three of these cases are reported in children. We recently treated a child with subscapular abscess. We performed the literature search using a combination of the keywords: subscapular, scapular, abscess and infection. One case was diagnosed on post-mortem autopsy, and only three of these cases are reported in children. The organism was Staphylococcus aureus in five cases (two were methicillin-resistant S. aureus), Haemophilus influenzae in one case, and no organism was grown in the last case. (Patient received a course of empirical antibiotics and samples did not grow any organism.) We describe a case of spontaneous subscapular abscess in a 7-year-old boy. The abscess was visualised on magnetic resonance imaging (MRI), and the organism was identified as S. aureus bacteria. The abscess was treated surgically with debridement and antibiotics, and the patient had full recovery with no subsequent effects. Subscapular abscess needs high index of suspicion and early imaging investigation. MRI is the modality of choice for accurate diagnosis. Early intervention leads to favourable outcome, while delays in diagnosis can be fatal.