Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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March 18, 2013
Intramedullary Spinal Cord Abscess
- Intramedullary cord abscesses are uncommon.
- Etiology: the most common organisms are Staphylococcus and Streptococcus species, followed by gram-negative organisms and mixed flora. In most of the cases, the routes of infection are idiopathic/cryptogenic.
- Clinical presentation: symptoms of infection and neurological findings, related to the level of spinal cord involvement. Most common location: thoracic spinal cord.
- Key Diagnostic Features: MRI with contrast administration: Ring-enhancing mass within the spinal cord, with appropriate clinical history of inflammation/infection
- DDx: Intramedullary tumors, acute transverse myelitis, MS, cord infarction
- Rx: antibiotics; surgical debridement indicated if neurologic symptoms progress during medical therapy
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