Intramedullary Spinal Cord Abscesses Research Articles

A Therapeutic Dilemma of Venous Thromboembolism in the Setting of Odontogenic Brain and Intramedullary Spinal Cord Abscesses: Case Report and Review of Literature (P12-7.004)

A Therapeutic Dilemma of Venous Thromboembolism in the Setting of Odontogenic Brain and Intramedullary Spinal Cord Abscesses: Case Report and Review of Literature (P12-7.004)

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.

Disseminated coccidioidomycosis presenting with intramedullary spinal cord abscesses: Management challenges

Coccidioides species are endemic to the southwestern United States and typically cause a mild or asymptomatic primary infection. In some instances, infection can disseminate and involve the central nervous system with meningitis being the most common manifestation. Non-osseous spinal cord involvement is exceedingly rare. We report a case of disseminated coccidioidomycosis in an otherwise healthy 20 year old man with diffuse leptomeningeal enhancement, cerebrospinal fluid findings suggestive of meningitis, and intramedullary spinal cord abscesses. Response to treatment occurred with prolonged systemic liposomal amphotericin B and voriconazole. An extended course of steroids was needed to blunt inflammation.

Proteus mirabilis abscess involving the entire neural axis

Intramedullary spinal cord abscesses are rare and potentially devastating lesions usually associated with other infective processes such as bacterial endocarditis, or pulmonary or urogenital infection. We describe a 2-year-old girl who presented with an infected dermal sinus leading to an intraspinal abscess. This abscess eventually spread and involved the entire neural axis leaving her quadriparetic. Drainage of the abscess resulted in recovery and the child regained normal function of her limbs. To our knowledge this is the first documented case of an intramedullary abscess involving the entire neural axis.

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.

Neglected intramedullary cord abscess in a 3-year old child: a case report

Intramedullary spinal cord abscesses are rare and can be potential harmful lesions that cause a variety of neurologic problems. It is a treatable cause of paraparesis; however, diagnosis is not often straightforward due to the indolent course and rarity of the disease. We report a case of a 32-month-old boy referred to our institution with a neglected intramedullary cord abscess after 6 months. Strong clinical suspicion, in addition to prompt surgical drainage with proper antibiotic therapy, seems crucial in prevention of permanent neurological disability.

Intramedullary spinal cord abscess complicating thoracic spondylodiscitis caused by Bacteroides fragilis

Intramedullary spinal cord abscess associated with infectious spondylodiscitis is a rare entity. The case of a 66-year-old man with an intramedullary spinal cord abscess complicating thoracic spondylodiscitis is presented. The patient was unable to ambulate independently due to weakness of the legs. MR imaging showed findings suggestive of infectious spondylodiscitis at the T5-T6 level associated with epidural and intramedullary spinal cord abscesses. Biopsy of the intervertebral disc was performed and Bacteroides fragilis was isolated. Antibiotic therapy was instituted, and MR imaging of the thoracic spine was performed 6 weeks after the initiation of treatment, showing resolution of the epidural and intramedullary spinal cord abscesses.

Abcès intramédullaire chronique (streptococcus sanguis): Cas clinique et revue de la littérature

Chronic intramedullary spinal cord abscesses are very rare. We present here a new case of this pathology, revealed by a progressive spinal cord compression. This case is particular because of the long follow up before surgery (two years).This 69-year-old patient presented a gradually progressive paraparesis and sensory loss associated with leg pain. The past medical history was dominated by a epidermoid cancer of the tongue. MRI showed an intramedullary mass at T10. On the T1-weighted sequences, the lesion was isointense with the spinal cord, Gadolinium infusion showed homogeneous enhancement of the lesion. T2-weighted sequences showed decreased signal within the lesion and an increased signal peripherally (edema). Corticosteroid infusions relieved the symptoms so the patient declined surgery. Two episodes of regressive paraplegia were treated by the same infusions. The patient accepted surgery after a third episode.The intervention was performed two years after the first signs and revealed a hard white mass attached to the spinal cord. Pathologic examination showed infectious inflammation. Bacteriological cultures found a Streptococcus sanguis. Two years later the patient could walk; a minimal deficit persists.First, the diagnosis was evoked but not retained because of the long course. The corticosteroid infusions gave relief and did not increase the deficit. The MRI findings remained unchanged. Intramedullary spinal cord abscesses are very rare. This pathology must be recognized because without treatment morbidity is high with a potentially fatal outcome.

Intramedullary Abscess Associated with a Spinal Cord Ependymoma

Intramedullary spinal cord abscesses are relatively uncommon. We report the first case of an intramedullary spinal cord abscess in a preexisting spinal cord ependymoma. The clinical features and pathogenesis are discussed. Salient features of the management of intramedullary spinal cord abscesses are outlined.

Intramedullary spinal cord abscesses.

Intramedullary spinal cord abscesses are rare lesions that cause a variety of neurologic problems. This article reviews pathogenesis and symptoms associated with these lesions. In addition, specific nursing interventions for care of patients with intramedullary spinal cord abscesses are presented. These interventions focus on diagnostic testing, treatment options and a plan of care for patients diagnosed with this disease entity.