학술논문
Intramedullary spinal cord abscess as postoperative complication: A case report.
Document Type
Report
Author
Valeri AL; Department of Neurosurgery, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States.; Alayli A; Morsani College of Medicine, Tampa, FL, United States.; Gordon J; Morsani College of Medicine, Tampa, FL, United States.; Lockard G; Morsani College of Medicine, Tampa, FL, United States.; Tran ND; Department of Neurosurgery, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States.
Source
Publisher: Scientific Scholar LLC Country of Publication: United States NLM ID: 101535836 Publication Model: eCollection Cited Medium: Print ISSN: 2229-5097 (Print) Linking ISSN: 21527806 NLM ISO Abbreviation: Surg Neurol Int Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2229-5097
Abstract
Background: Intramedullary spinal cord abscesses (ISCA) can result in high morbidity and mortality if not treated in a timely manner. The incidence and outcomes of postsurgical ISCA are unknown. We present a case of a 52-year-old male patient with neurofibromatosis type 1 who developed an intramedullary spinal cord abscess after a previous resection of a cervical intradural, extramedullary neurofibroma.
Case Description: A 52-year-old male with a history of neurofibromatosis type 1 had previously undergone multiple resections of cervical intradural, extramedullary neurofibromas with internal stabilization. Sixteen months after his initial surgery, he developed acute-onset interscapular pain with bilateral lower extremity pain and left hemi-body weakness. Magnetic resonance imaging (MRI) of the cervical spine demonstrated an enlarging contrast-enhancing intramedullary lesion. Surgical exploration and evacuation of the lesion were completed. Intramedullary cultures confirmed a Serratia marcescens abscess. After abscess evacuation and intravenous antibiotics, the patient's symptoms resolved.
Conclusion: Given the potential for permanent neurologic damage and loss of independence with intramedullary spinal cord abscess, we advocate that clinicians maintain a high index of suspicion in the postsurgical patient. Diagnostic imaging through contrasted MRI or computed tomography myelogram should be obtained, and prompt intervention, including evacuation and/or antibiotics, should be implemented for the best chance of a favorable outcome.
Competing Interests: There are no conflicts of interest.
(Copyright: © 2024 Surgical Neurology International.)
Case Description: A 52-year-old male with a history of neurofibromatosis type 1 had previously undergone multiple resections of cervical intradural, extramedullary neurofibromas with internal stabilization. Sixteen months after his initial surgery, he developed acute-onset interscapular pain with bilateral lower extremity pain and left hemi-body weakness. Magnetic resonance imaging (MRI) of the cervical spine demonstrated an enlarging contrast-enhancing intramedullary lesion. Surgical exploration and evacuation of the lesion were completed. Intramedullary cultures confirmed a Serratia marcescens abscess. After abscess evacuation and intravenous antibiotics, the patient's symptoms resolved.
Conclusion: Given the potential for permanent neurologic damage and loss of independence with intramedullary spinal cord abscess, we advocate that clinicians maintain a high index of suspicion in the postsurgical patient. Diagnostic imaging through contrasted MRI or computed tomography myelogram should be obtained, and prompt intervention, including evacuation and/or antibiotics, should be implemented for the best chance of a favorable outcome.
Competing Interests: There are no conflicts of interest.
(Copyright: © 2024 Surgical Neurology International.)