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

Abstract

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.

Cervical Intramedullary Spinal Cord Abscess Secondary to Discitis and Osteomyelitis in an Immunocompromised Patient

“…Intramedullary spinal cord abscess is a rare diagnosis of the central nervous system. Approximately 200 cases have been reported in the literature [ 1 , 2 , 4 ]. ISCA may occur in immunocompromised patients due to the secondary spread of an ongoing infection [ 5 ].…”

“…Prompt recognition and intervention are crucial to offer our patients the best expectations. ISCA frequently presents with motor deficits in about 90% of the cases [ 1 , 2 ]. Other symptoms include sensory alterations, infection signs, and bowel or urinary dysfunction [ 2 ].…”

“…ISCA frequently presents with motor deficits in about 90% of the cases [ 1 , 2 ]. Other symptoms include sensory alterations, infection signs, and bowel or urinary dysfunction [ 2 ]. Magnetic resonance imaging (MRI) is the gold standard for diagnosis.…”

“…In misdiagnosed cases, where a prompt diagnosis is of paramount importance, most patients had permanent neurological deficits such as paraplegia or profound loss of sensation. A recent literature review found that approximately 20% of the cases presented with chronic ISCA, 29% were acute, and 33% were subacute [ 2 ]. We present the case of an immunocompromised male patient who developed a chronic cervical ISCA after being treated for multiple abscesses in the lumbar paravertebral and psoas muscles.…”

Intramedullary Spinal Cord Abscess with Concomitant Spinal Degenerative Diseases: A Case Report and Systematic Literature Review

“…The first case of a patient with ISCA was reported by Hart in 1830 [ 1 , 2 ]. Currently, fewer than 140 ISCA cases have been reported in the literature [ 3 ]. The mortality rate and outcome of these infections were improved when antibiotics, advanced neuroimaging modalities, and immediate surgery were accepted into clinical practice.…”