Intramedullary spinal cord abscess as complication of lumbar puncture: a case-based update

Silva, Paulo Sérgio Lucas da; Loduca, Rafael Duarte de Souza

doi:10.1007/s00381-013-2093-9

Cited by 15 publications

(13 citation statements)

References 39 publications

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“…In those cases, the mechanism of infection is direct inoculation of germs into the spinal cord. 10,11 In children, intramedullary abscess formation is often a complication of congenital neuroectodermal infection, generally located in the lumbar segment. 12,13 S. aureus is the most frequent pathogen to cause bacterial ISCA, 6 the causative micro-organism in our case.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary abscess associated with acute bacterial meningitis: a case report and review of the literature

Hammoud¹,

Lakhdar²,

Benzagmout³

et al. 2020

JNSK

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Intramedullary spinal cord abscess (ISCA) is a rare infection of the central nervous system. Untreated, it may result in significant morbidity and mortality. We describe the case of a 34-year-old man, who initially was admitted for bacterial meningitis. 3 days after initiation of antibiotic therapy, a gradually and progressive weakness appeared on the left side of his body with numbness on the contralateral side. MRI of the spine demonstrated an ISCA at level of C4. A myelotomy and surgical drainage was performed. Postoperatively, the patient had improved significantly his neurological deficit. ISCA is still a life-threatening condition, we point out that the diagnosis should be highly suspected, if a cystic spinal cord lesion is surrounded by significant medullar edema associated with fast onset of symptoms, especially in a context of sepsis or acuate meningitis. Prompt surgical evacuation followed by adequate antibiotic therapy, are the mainstays of treatment.

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Section: Discussionmentioning

confidence: 99%

Intramedullary abscess associated with acute bacterial meningitis: a case report and review of the literature

Hammoud¹,

Lakhdar²,

Benzagmout³

et al. 2020

JNSK

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“…The authors of the first description of intramedullary abscess formation reported that it occurred after spinal anesthesia following a penetrating trauma to the spinal cord [ 32 ]. Other authors have reported cases of penetrating injuries that were coincidental with intramedullary abscess formation after a stab wound [ 33 ], spinal puncture [ 34 , 35 ], and transpharyngeal stab injury [ 36 ], with the most likely mechanism of infection of direct introduction microorganisms into the spine.…”

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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“…In total, 122 papers potentially pertaining to the topic of the study were enrolled in the full-text assessment for eligibility. In these 122 papers, we identified 58 papers regarding pediatric ISCA with the description on 64 cases [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ].…”

Section: Literature Searchmentioning

confidence: 99%

“…The course of ISCA can be divided into acute (<1 week), subacute (1–6 weeks), and chronic (>6 weeks) [ 44 ]. The most frequently observed manifestation was acute: 25 (39.06%) followed by 21 (32.81%) subacute cases.…”

Section: What Is Currently Known About Intramedullary Spinal Cord Abs...mentioning

confidence: 99%

What Is Currently Known about Intramedullary Spinal Cord Abscess among Children? A Concise Review

Szmyd

Jabbar

Lusa

et al. 2022

JCM

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Intramedullary spinal cord abscesses (ISCA) are rare. Typical symptoms include signs of infection and neurological deficits. Symptoms among (younger) children can be highly uncharacteristic. Therefore, prompt and proper diagnoses may be difficult. Typical therapeutic options include antibiotics and neurosurgical exploration and drainage. In this review, we analyze published cases of ISCA among children. Most pediatric cases were found to be under the age of 6 years. The typical symptoms included motor deficits in 89.06%, infection signs in 85.94%, and sensory deficits in 39.06%. Urinary dysfunction was observed in 43.75%, and bowel dysfunction in 17.19%. The predisposing factors included dermal sinuses, (epi)dermoid cysts, prior infection, iatrogenic disorder, and trauma. The most common pathogens were: Staphylococcus aureus, Mycobacterium tuberculosis, Escherichia coli, and Proteus mirabilis. The pediatric population has good outcomes as 45.93% of patients had complete neurological recovery and only 26.56% had residual neurological deficits. Fifteen (23.44%) had persistent neurological deficits. Only one (1.56%) patient died with an ISCA. In two (3.13%) cases, there were no details about follow-up examinations.

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Intramedullary spinal cord abscess as complication of lumbar puncture: a case-based update

Cited by 15 publications

References 39 publications

Intramedullary abscess associated with acute bacterial meningitis: a case report and review of the literature

Intramedullary abscess associated with acute bacterial meningitis: a case report and review of the literature

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

What Is Currently Known about Intramedullary Spinal Cord Abscess among Children? A Concise Review

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