[Paraplegia associated with intramedullary spinal cord and epidural abcesses, meningitis and spondylodiscitis (Staphylococcus aureus)]

Abstract

Introduction: Intramedullary spinal cord abscesses are rare, frequently associated with meningitis, sometimes with epidural abscesses. They are frequently responsible for paraplegia. Staphylococcus aureus is the predominant organism. MRI shows an intramedullary collection giving a low-intensity signal on T1-weighted images with peripheral contrast uptake on enhanced TI-weighted studies and a high-intensity signal on T2-weighted images with generally extended adjacent medullary edema. They may be multiple.

Case report: We report the case of a man who presented meningitis with intramedullary and epidural abscesses. The number of the lesions did not allow chirurgical drainage. The paraplegia did not resolve despite appropriate antibiotic therapy.

Conclusion: Appropriate antibiotic therapy and early surgical drainage, if feasible, are key factors for better outcome and prognosis.