Acute intramedullary spinal cord abscess: Case report

Erlich, Jonathan; Rosenfeld, J. V.; Fuller, Andrew; Brown, Graham V.; Wodak, Jack; Tress, Brian P.

doi:10.1016/0090-3019(92)90043-m

Cited by 23 publications

(13 citation statements)

References 13 publications

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“…9,[11][12][13] It is usually closely adherent to the inner aspect of the dura and to the cord into which it penetrates like a crater, so in occasional cases it becomes very difficult to define whether the intradural tuberculoma is extramedullary or intramedullary. 13,14 Intramedullary spinal cord abscess is a rare clinical entity and only 83 cases [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] have been reported in the literature since the original case documented by Hart in 1830. 25 Abscess formation becomes manifest by the accumulation of the necrotic tissue, debris and caseous material as the disease progresses.…”

Section: Discussionmentioning

confidence: 99%

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Atypical intradural spinal tuberculosis: report of three cases

et al. 2003

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Objective: To report three cases of intradural spinal tuberculosis (TB) by calling attention to atypical forms of spinal TB. Setting: A University Hospital, Istanbul, Turkey. Methods: Histopathological, radiological, surgical and physical examination findings of three patients with spinal TB were retrospectively reviewed. Results: Based on histopathological, surgical and radiological findings, diagnosis of intramedullary abscess had been made in the first case and early and late phases of arachnoiditis in the other two patients, respectively.The clinical outcome was evaluated as satisfactory for the patient with intramedullary abscess who had been treated with medical and surgical interventions. The remaining two patients with arachnoiditis, who had been treated by shunting or simple decompression, had a relatively less favorable clinical outcome. Conclusion: Spinal TB, in its atypical forms, is a rare clinical entity and low index of suspicion on the part of the surgeon may result in misdiagnosis such as neoplasm. In cases presenting with an intraspinal mass lesion, possibility of a tuberculous abscess and/or a granuloma should be considered in the differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

“…8,38 Gadolinium-diethylenetriaminepentaacetic acid-enhanced MRI study helps to demonstrate the classical ring sign of an abscess, 23,31 and can also differentiate myelomalacia from a syrinx. It should be the radiological study of choice in both the diagnosis and the follow-up of this disorder.…”

Section: Discussionmentioning

confidence: 99%

Atypical intradural spinal tuberculosis: report of three cases

et al. 2003

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“…Dermal sinus tract, which results from the incomplete partition of epithelial ectoderm and neuroectoderm in the early fetal life, is to be implicated as a source of this pathology in children, it can end anywhere along its tract within the spinal canal compartments and becomes a potential route for spread of infection. Spinal cord abscess may involve any part of the spinal cord but the thoracolumbar spine is the most frequent site; however; holocord abscess may occur but it is less common [8,11,21]. Clinical suspicion and radiological findings are essential for early diagnosis and treatment; consequently, irreversible spinal cord damage can be avoidable.…”

Section: Introductionmentioning

confidence: 99%

Management of intramedullary spinal cord abscess: experience with four cases, pathophysiology and outcomes

et al. 2009

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Intramedullary spinal cord abscess (ISCA) in children is extremely a rare infection of the central nervous system (CNS); and probably a devastating neurological condition. Clinical awareness of patients at risk is crucial for early diagnosis and intervention; as this entity is one of the treatable conditions of paraparesis. Association with congenital neuro-ectodermal abnormality in children is frequent. This pathology highlights the importance of complete neurological checks of infants as a part of their routine physical examination and early management of patients with congenital dermal sinus, prophylactic surgical resection of such a congenital anomaly is recommended by most authors to prevent serious infections of the CNS. However, once the abscess is established; immediate surgical drainage along side adequate antibiotics should be instituted. This may guarantee improving neurological outcome. In this communication, the authors present their experience with four cases of ISCA in children treated successfully with surgical drainage, intravenous antibiotics and neuro rehabilitation between 2001 and 2006 and discuss their results. We concluded that early diagnosis and treatment is essential; before a devastating mechanico-vascular insult of the spinal cord is established from rapid formation of the abscess and a swift expansion of the spinal cord within the limited intraspinal space.

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“…Many other microorganisms have been implicated in the formation of intramedullary abscesses, such as Candida albicans [ 9 ], Nocardia asteroides [ 10 ], Listeria monocytogenes [ 11 , 12 ], Cryptococcus neoformans [ 13 ], Brucella [ 14 ], Scedosporium apiospermum [ 15 ], Histoplasma capsulatum [ 16 ], group F Streptococcus [ 17 ], Bacteroides disiens [ 18 ], Streptococcus melleri [ 19 ], and Aspergillus fumigatus [ 20 ]. Many of these patients have an underlying immunocompromised predisposition, such as human immunodeficiency virus (HIV) infection or agammaglobulinemia.…”

Section: Discussionmentioning

confidence: 99%

Streptococcus pneumoniae meningitis complicated by an intramedullary abscess: a case report and review of the literature

Cravens

Germann

2016

J Med Case Reports

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BackgroundIntramedullary abscess is a rare neurosurgical condition that usually arises in the setting of penetrating trauma to the spinal cord, infected congenital dural sinuses, or tuberculosis.Case presentationWe describe a case of a 35-year-old African American male who presented with sepsis and a clinical picture of meningitis. The patient continued to have declining neurological status with decreasing sensation and worsening motor strength in all four extremities. He was found to have an intramedullary abscess in the cervical spinal cord that was treated with a decompressive posterior cervical laminectomy and drainage. The patient began to have a partial recovery of neurological function postoperatively. We also review the literature on intramedullary abscess that suggests the clinical presentation of our patient was a rare complication of acute meningitis.ConclusionsIntramedullary abscess formation is a rare entity, and a high index of suspicion for intramedullary abscess is the key for making the diagnosis and expediting treatment for these patients.

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Acute intramedullary spinal cord abscess: Case report

Cited by 23 publications

References 13 publications

Atypical intradural spinal tuberculosis: report of three cases

Atypical intradural spinal tuberculosis: report of three cases

Management of intramedullary spinal cord abscess: experience with four cases, pathophysiology and outcomes

Streptococcus pneumoniae meningitis complicated by an intramedullary abscess: a case report and review of the literature

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