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Ruptured long intramedullary spinal cord abscess successfully treated with antibiotic treatment
Takayoshi Akimoto1, Satoshi Hirose1, Tomotaka Mizoguchi1
1Division of Neurology, Department of Medicine, Nihon University School of Medicine, Japan.
Summary
Intramedullary spinal cord abscess (ISCA) is rare. Early MRI diagnosis and antibiotics improved a patient
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Intramedullary spinal cord abscess (ISCA) is an exceptionally rare central nervous system infection.
- Prompt diagnosis and treatment are crucial for favorable outcomes.
Observation:
- A 17-year-old male presented with symptoms of ISCA, including paraplegia and sensory deficits.
- Magnetic resonance imaging (MRI) confirmed ISCA and suggested abscess rupture.
- Infectious sources included maxillary sinusitis and lower respiratory tract infection.
Findings:
- Cerebrospinal fluid (CSF) analysis indicated bacterial meningitis.
- Streptococcus intermedius was identified as the causative pathogen in CSF, sputum, and sinus abscess.
- The patient recovered with intravenous antibiotic therapy (ampicillin, vancomycin, meropenem) and physiotherapy.
Implications:
- MRI is vital for the early diagnosis and monitoring of ISCA.
- Aggressive antibiotic treatment, guided by early diagnosis, is critical for improving patient prognosis.
- This case highlights the potential for hematogenous spread from respiratory infections to the spinal cord.
