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April 10, 2007; 68 (15) NeuroImages

Intramedullary spinal cord abscess in a healthy woman

A. Applebee, M. Ramundo, B. D. Kirkpatrick, T. J. Fries, H. Panitch
First published April 9, 2007, DOI: https://doi.org/10.1212/01.wnl.0000250231.86932.04
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This article has a correction. Please see:

A 47-year-old woman reported burning abdominal discomfort, urinary retention, and leg paresthesias 1 week after dental cleaning. Examination revealed right leg weakness and sensory loss to T10. MRI showed an intramedullary ring-enhancing lesion at T8 (figure, A). By day 7, she was paraplegic with a T3 sensory level. Repeat MRI showed edema from C3 to the conus medullaris, with C7 to T11 enhancement (figure, B). Urgent abscess drainage was performed. Paraplegia and a T4 sensory level remained despite radiographic resolution (figure, C). Cultures revealed oral flora. Early broad-spectrum antibiotic therapy is indicated when intramedullary spinal cord abscess is suspected.1

Figure

Figure. (A) Sagittal T2-weighted MRI of the thoracic cord (day 1) demonstrates an intramedullary ring enhancing lesion at T8. (B) Sagittal T2 (day 4) showing enlargement of the lesion extending superiorly to T3 and inferiorly to T11. (C) Sagittal T2 image (1 year out) with resolving abnormal signal at T6-T9.

1.

Chan CT, Gold WL. Intramedullary abscess of the spinal cord in the antibiotic era: clinical features, microbial etiologies, trends in pathogenesis, and outcomes. Clin Infect Dis 1998;27:619–626.
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  • See also page 1231

    Disclosure: The authors report no conflicts of interest.

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