Intramedullary Spinal Cord Abscess Research Articles

Intramedullary Spinal Cord Abscess in an Adult Patient: A Case Report

Intramedullary Spinal Cord Abscess in an Adult Patient: A Case Report

Intramedullary Spinal Cord Abscess Caused by Acupuncture.

Intramedullary Spinal Cord Abscess Caused by Acupuncture.

Intramedullary spinal cord abscess due to disseminated hypermucoviscous Klebsiella pneumoniae infection: A rare case report

Intramedullary spinal cord abscess due to disseminated hypermucoviscous Klebsiella pneumoniae infection: A rare case report

A Rare Case of Cervical Intramedullary Spinal Cord Abscess

A Rare Case of Cervical Intramedullary Spinal Cord Abscess

Intramedullary Spinal Cord Abscess Due to Traumatic Esophageal Perforation Associated with Cervicothoracic Anterior Osteophytes: A Case Report

Intramedullary Spinal Cord Abscess Due to Traumatic Esophageal Perforation Associated with Cervicothoracic Anterior Osteophytes: A Case Report

Concomitant brain abscess and spinal cord abscess in an immunocompetent teenage male: illustrative case.

Multiple bilateral brain abscesses occur rarely in immunocompetent patients. Hematogenous spread to the central nervous system (CNS) allows suppuration and abscess formation in the privileged immune environment of the CNS; hematogenous spread to the spinal cord is extremely rare and the combination of multifocal brain abscesses and intramedullary abscesses has not been reported. This report presents a rare presentation and diagrams a treatment algorithm involving iterative minimal access surgeries and prolonged medical management. The authors present a case of an 18-year-old male with numerous multifocal and bilateral intraparenchymal abscesses and a medically resistant C5 intramedullary spinal cord abscess. The symptomatic patient had a left oculomotor palsy and left hemiparesis, ultimately undergoing ultrasound-guided aspiration of abscesses in the left frontal and left cerebral peduncle. Following transient motor improvement, he evolved tetraparesis prompting spinal cord imaging and emergent ultrasound-guided needle aspiration of an occult C5 intramedullary spinal cord abscess. The patient received appropriate medical therapy, completed inpatient rehabilitation, and made a full recovery. Needle- and ultrasound-guided catheter drainage of CNS abscesses should be considered for symptomatic lesions. Following the neurological examination closely is extremely important; if the expected neurological improvement is delayed or regresses, then expanded imaging is warranted.

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

Intramedullary spinal cord abscess (ISCA) is a rare clinical pathology of the central nervous system that usually accompanies other underlying comorbidities. Traditionally it has been associated with significant mortality and neurological morbidities because it is often difficult to diagnose promptly, owing to its nonspecific clinical and neuroimaging features. The mortality rate and the outcome of these infections have been improved by the introduction into clinical practice of antibiotics, advanced neuroimaging modalities, and immediate surgery. We report the case of a 65-year-old male patient who presented with a progressive spastic gait and lumbar pain, predominantly in the left leg. An MRI image revealed an expansile intramedullary cystic mass in the thoracic spinal cord, which was initially diagnosed as a spinal tumor. He underwent laminectomy and myelotomy, and eventually the pus was drained from the abscess. The follow-up MRI showed improvement, but the patient’s paraplegia persisted. In light of his persistent hypoesthesia and paraplegic gait with developing neuropathic pain, he was readmitted, and an MRI of his lumbar spine revealed multilevel degenerative disease and tethered spinal cord syndrome with compression of the medulla at the L2–L3 level. The patient underwent central flavectomy with bilateral foraminotomy at the L2–L3 level, and the medulla was decompressed. Postoperatively, his neurological symptoms were significantly improved, and he was discharged from hospital on the third day after admission. In support of our case, we systematically reviewed the recent literature and analyzed cases published between 1949 and May 2022, including clinical features, mechanisms of infection, predisposing factors, radiological investigations, microbial etiologies, therapies and their duration, follow-ups, and outcomes. Initial clinical presentation can be misleading, and the diagnosis can be challenging, because this condition is rare and coexists with other spinal diseases. Hence, a high index of suspicion for making an accurate diagnosis and timely intervention is required to preclude mortality and unfavorable outcomes. Our case is a clear example thereof. Long-term follow-up is also essential to monitor for abscess recurrences.

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

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.

Intramedullary spinal cord abscess: A grave complication of a dermal sinus tract

Congenital dermal sinus tracts are an uncommon form of spinal dysraphism. If identified and treated early, outcomes are favourable. If missed, complications can be significant. Intramedullary spinal cord abscess is a rare but catastrophic complication. We report the case of an infantile patient with an intramedullary spinal cord abscess occurring 2-months post treatment for a coliform meningitis with an unidentified dermal sinus tract. We examined the literature on the investigation and management of dermal sinus tracts and conclude that all cases of unexplained, atypical meningitis in an infant should trigger suspicion for an underlying dermal sinus tract. In such cases, an MRI scan of the neuroaxis should be performed urgently. Keywords: syrinx; dimple; meningitis; dysraphism.

Intramedullary spinal cord abscess—rare complication of a congenital dermal sinus: Report of a case in a toddler

Abstract Lumbosacral region is the commonest location for a dermal sinus (DS). The DS provides a natural pathway for infections of the deeper tissues such as the meninges or spinal cord, depending on its termination. One of the rarest and serious complications of a DS is an intramedullary spinal cord abscess. One such case has been reported here. A 2-year boy presented with high-grade fever, acute onset flaccid paraplegia and urinary retention. A L5 level DS was noted. Imaging showed a D12-L5 heterogeneously enhancing intradural lesion suggestive of an abscess. Multi-level laminectomy and drainage of abscess with removal of an inclusion epidermoid was performed. Complete recovery of all neurological functions was achieved that remained stable at 60 months follow up.

Intramedullary Spinal Cord Abscess: A Systematic Review of 121 Reported Cases (2353)

Intramedullary Spinal Cord Abscess: A Systematic Review of 121 Reported Cases (2353)

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

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.

Spinal Intramedullary Abscess Secondary to Dermal Sinus in Children.

Congenital dermal sinuses (CDS) are uncommon lesions. They are most often noted in lumbosacral region and may lead to meningitis or spinal abscess. Intramedullary spinal cord abscess (IMSCA) due to CDS is rare and often co-exists with an inclusion tumor such as dermoid/epidermoid cyst. Literature review was done to analyze all cases of pediatric IMSCA secondary to CDS by searching online databases starting from the oldest case reported. Only 50 cases have been reported and were analyzed. Mean age was 22.6 months (range 1 month-15 years). Fever, acute flaccid lower limb weakness, and urinary disturbances were the most common presenting features. Dermal sinus was commonest in lumbosacral region. Inclusion cysts were observed in 50% of cases. Staphylococcus aureus was the most the common organism. Mean follow-up duration was 18.2 months (range 1 week-156 months). Majority of the cases underwent multilevel laminectomy with myelotomy and drainage of abscess. Outcome was good-to-excellent in around 60% cases with four deaths. Presence of fever and limb weakness was significantly associated with poor outcomes. Intramedullary abscess secondary to CDS is very rare. Complete sinus tract excision, myelotomy and drainage of abscess, and decompression of co-existent inclusion cysts with prolonged antibiotic therapy remain the standard treatment. Approximately 60% cases achieve good outcomes. Fever and limb weakness portend poorer outcomes than those without.

Intramedullary Spinal Cord Abscess: Illustration of Two Cases and Review of Literature

Intramedullary spinal cord abscess is a rare infection of the spinal cord with less than 120 cases reported since its first description by Hart in 1830. It is usually associated with abnormalities of the spinal cord or documented source of infection or immunodeficiency, requiring clinical radiological suspicion for accurate diagnosis. The first case is a middle-aged healthy woman without any underlying risk factors, presented with progressive paraparesis, in whom prompt, accurate diagnosis with contrast magnetic resonance imaging, diffusion-weighted imaging, and apparent diffusion coefficient mapping followed by early surgery was possible, which resulted in the favorable neurological outcome. The second case is a 10-year-old boy with paraparesis whose definite treatment and surgery was delayed due to a delay in accurate clinical and radiological diagnosis which resulted in poor outcomes. Hence, we try to establish that prompt diagnosis and surgical treatment can result in a favorable neurological outcome, though the prognosis, in general, is poor in this clinical condition. A review of literature in support of our cases is given.

Cervical spinal dermal sinus associated with intramedullary spinal cord abscess

A female, aged 21 months, presented with fever and an orifice with output of purulent material, observed in the upper cervical region. Spinal and brain MRI are displayed in . The radiological diagnosis, with subsequent histopathologic confirmation, was dermal sinus associated with intramedullary spinal cord abscess. […] Cervical spinal dermal sinus associated with intramedullary spinal cord abscess

Intramedullary Spinal Cord Abscess; Descriptive Review of the Literature (P2.015)

Intramedullary Spinal Cord Abscess; Descriptive Review of the Literature (P2.015)

Currarino syndrome with intramedullary spinal cord abscess related communication between the tethered cord and a presacral mass: A case report

Abstract We herein report the case of a 21-day-old boy in which the detection of an intramedullary spinal cord abscess led to the diagnosis of Currarino syndrome (CS). He had a complete phenotype of CS, including sacral agenesis, an anorectal malformation, a presacral mass, and spinal cord malformations. In addition, he had an intramedullary spinal cord abscess. Intramedullary spinal cord abscess is rare in CS and is thought to require immediate intervention. Therefore, we additionally reviewed the available literature and discussed the therapeutic approach for CS with an intramedullary cord abscess.

Intramedullary abscess extending to the cauda equina with paraplegia in a 6-month-old infant

Intramedullary spinal cord abscesses are uncommon lesions. Forty percent of all such abscesses occur before 20 yr of age. Patients with acute onset of symptoms and signs have a graver prognosis. This generally occurs in the setting of systemic bacteremia. A case of large intramedullary spinal cord abscess extending up to the terminal spinal canal in a 6-month-old male baby who developed flaccid paraplegia without an evidence of systemic infection or septicemia or anatomical defect is reported. The possibility of infection of an epidermoid in such cases cannot ruled out.

Intramedullary spinal cord abscess – an unusual presentation

Intramedullary spinal cord abscess (ISCA) is a rare infection in children. It is usually associated with congenital neuro-ectodermal abnormalities. Spastic paraparesis is the predominant clinical presentation. We report a child of ISCA who presented with acute flaccid paralysis of both lower limbs, an unusual presentation and yet showed significant neurological improvement.

Intramedullary spinal cord abscess by Nocardia: A case report

Introduction: Nocardia is a Gram-positive bacteria that usually cause opportunistic infections but can affect the immunocompetent host. The central nervous system can be the primary site of infection in up to 40% of the cases but the involvement of the spinal cord is extremely rare. Case Report: We present a case of a middle age man with history of alcoholic liver cirrhosis and diabetes mellitus who presented with acute lower back pain that is associated with right leg weakness and numbness. Magnetic resonance imaging (MRI) scan showed a spinal cord intramedullary abscess. The cerebrospinal fluid analysis was consistent with meningitis and the organism was eventually identified with CSF culture as Nocardia Farcinica. Patient was treated with prolonged intravenous trimethoprim/sulfamethoxazole and meropenem. No neurosurgical intervention was done and the patient had full neurological recovery in few months. Discussion: Nocardia species are able to cause different kinds of disease in man. Spinal cord abscess are extremely rare and high index of clinic suspicion is required for diagnosis. Initial combination intravenous antibiotics treatment is essential and should be continued for at least three to six weeks. Treatment can be switched to oral and continued for a minimum of six months. Surgical intervention might be indicated in some patients. 16s rRNA gene sequencing allows earlier identification and thus adjustment of antibiotics. Conclusion: This report illustrates that a diagnosis can be made by neuroimaging and cerebrospinal fluid (CSF) 16s ribosomalRNA sequencing, allowing early and effective antibiotic therapy and obviating the need for a high-risk neurosurgical intervention.