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Intramedullary spinal cord abscess involving Actinomyces and Streptococcus: a case report and literature review

Shunsuke Nakamura1, Hiroya Shimauchi-Ohtaki2, Fumiaki Honda1

  • 1Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

Spinal Cord Series and Cases
|February 17, 2024
PubMed
Abstract

Insights

This case highlights a rare mixed Streptococcus and Actinomyces infection causing an intramedullary spinal cord abscess (ISCA). Prompt, targeted antibiotic therapy is crucial for treating this serious central nervous system infection.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Microbiology

Background:

  • Intramedullary spinal cord abscesses (ISCAs) are uncommon but serious central nervous system infections.
  • Polymicrobial infections are rare in ISCAs, making pathogen identification critical for effective treatment.
  • This report details an exceptionally rare ISCA caused by a mixed Streptococcus and Actinomyces infection.

Approach:

  • A case study of an 82-year-old male presenting with cervical pain and quadriplegia.
  • Radiological imaging identified a C3-4 level mass with marginal enhancement.
  • Surgical drainage and subsequent antibiotic therapy were employed.

Key Points:

  • Identification of both Streptococcus and Actinomyces as causative agents in the ISCA.
  • Successful treatment outcome following targeted antibiotic administration.
  • Demonstrates the potential for mixed infections to cause ISCA.

Conclusions:

  • Mixed infections, including Actinomyces, can lead to the development of ISCA.
  • Effective ISCA management necessitates prompt identification and pathogen-directed antibacterial therapy.

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