A Case of Intramedullary Spinal Abscess: A Case Report

A 31 year old male was admitted to our hospital with severe upper thoracic pain, paraplegia and urinary difficulty. The patient have no history of infection or operation. At admission, neurologic examination revealed alert mental state, hypoesthesia below the level of T6 sensory dermatome. All deep tendon reflexes were hypoactive. Myelographic examination disclosed total blockage of T5 body level. ACT scan of the lumbar spine performed immediately after myelogram verified an intramedullary enlargement of the spinal cord. Laminectomy was performed from the T3 to T5. Yellowish discolorated pus was founded at the epidural space, and exuded out through dura perforation. Dura was incised and the abscess was removed. The intramedullary abscess was encountered and fibrous granulation tissue was partially enveloped the abscess. The abscess removed by repeated antibiotics mixed saline and suction. The organism from the abscess was identified as staphylococcus coagulase positive. Antibiotic therapy was continued for four weeks and steroid postoperatively. The patient's condition was slight improved sensory level, but motor power was still hemiplegia on discharge time