Intramedullary Tuberculous Abscess

Hancı, Murat; Sarıoğlu, Ayşe; Uzan, Mustafa; Işlak, Civan; Kaynar, Mehmet Yaşar; Öz, Büğe

doi:10.1097/00007632-199603150-00023

Cited by 50 publications

(43 citation statements)

References 20 publications

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“…Surgery is indicated for the evacuation of the pus and use of appropriate antibiotics and corticosteroids should be considered in the treatment. 16,27,31 Treatment of syringomyelia secondary to spinal TB consists of a shunting procedure, which has a limited success rate as occurred in our case 2.…”

Section: Discussionmentioning

confidence: 74%

“…9,[11][12][13] It is usually closely adherent to the inner aspect of the dura and to the cord into which it penetrates like a crater, so in occasional cases it becomes very difficult to define whether the intradural tuberculoma is extramedullary or intramedullary. 13,14 Intramedullary spinal cord abscess is a rare clinical entity and only 83 cases [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] have been reported in the literature since the original case documented by Hart in 1830. 25 Abscess formation becomes manifest by the accumulation of the necrotic tissue, debris and caseous material as the disease progresses.…”

Section: Discussionmentioning

confidence: 99%

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Atypical intradural spinal tuberculosis: report of three cases

et al. 2003

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Objective: To report three cases of intradural spinal tuberculosis (TB) by calling attention to atypical forms of spinal TB. Setting: A University Hospital, Istanbul, Turkey. Methods: Histopathological, radiological, surgical and physical examination findings of three patients with spinal TB were retrospectively reviewed. Results: Based on histopathological, surgical and radiological findings, diagnosis of intramedullary abscess had been made in the first case and early and late phases of arachnoiditis in the other two patients, respectively.The clinical outcome was evaluated as satisfactory for the patient with intramedullary abscess who had been treated with medical and surgical interventions. The remaining two patients with arachnoiditis, who had been treated by shunting or simple decompression, had a relatively less favorable clinical outcome. Conclusion: Spinal TB, in its atypical forms, is a rare clinical entity and low index of suspicion on the part of the surgeon may result in misdiagnosis such as neoplasm. In cases presenting with an intraspinal mass lesion, possibility of a tuberculous abscess and/or a granuloma should be considered in the differential diagnosis.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Atypical intradural spinal tuberculosis: report of three cases

et al. 2003

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“…Most of the reported cases shows that these abscess are mainly due to tubercular pathology [1,2,3,4,5,6]. Some of the reported cases shows that congenital dermal sinus and epidermoid cyst also causes abscess in this region.…”

Section: Introductionmentioning

confidence: 99%

Conus intramedullary pyogenic abscess in a 4years old child: a rare case report and review of literature

Prasad¹,

Kumar²,

Kumar³

et al. 2017

Romanian Neurosurgery

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“…Immune-compromised patients are also affected by spinal TB infection in developed countries. A small number of cases with abscess of the spinal cord due to tuberculosis have been reported in the literature [1][2][3]. It may cause neurological symptoms as seen in spinal cord neoplasms.…”

mentioning

confidence: 99%

“…Spinal cord TB abscess is a rare clinical entity; few cases have been reported in the literature [1][2][3]. The clinical presentation of spinal cord TB abscess is characterized by fever and back pain, and, according to the localization of the abscess in the spinal cord, shoulder, hip or extremity pain can occur.…”

mentioning

confidence: 99%

Recurrent intradural spinal tuberculosis abscess in a child – follow-up magnetic resonance imaging

Karabina¹,

Korkmaz²,

Aydın³

et al. 2016

Arch Med Sci Civil Dis

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Tuberculosis (TB) is a common cause of spinal infection in underdeveloped and developing countries. Immune-compromised patients are also affected by spinal TB infection in developed countries. A small number of cases with abscess of the spinal cord due to tuberculosis have been reported in the literature [1][2][3]. It may cause neurological symptoms as seen in spinal cord neoplasms. Because of the good response to quick treatment, early diagnosis is very important for sufficient recovery of symptoms. We report a case of a child with a recurrent spinal intradural tuberculosis abscess, which is seen rarely in childhood.The 7-year-old female patient had a history of surgery due to spinal tuberculosis abscess. Gram stains for bacteria were negative, but acid-alcohol-fast bacilli were found in the specimen. A diagnosis of tuberculosis was made based on the microbiological studies. Tuberculosis antibiotherapy (isoniazid + rifampicin + pyrazinamide + ethambutol) was started after the surgery, but treatment had to stopped due to increasing liver enzymes (ALT, AST, LDH, GGT) after 2 months. Three months after the surgery she was referred to our hospital pediatric clinic with fever, hip pain and abdominal pain and also urinary incontinence. There was no spinal tenderness, no headache, no stiff neck, and no weakness of lower extremities. Knee and ankle jerks were normoactive bilaterally. Sensory examination was normal. Laboratory examination showed a white blood cell count (WBC) of 8.55/mm 3 , hemoglobin 12 g/dl and an erythrocyte sedimentation rate (ESR) of 11 mm/h, C-reactive protein (CRP) 1,2 mg/ dl. Rheumatologic tests were normal. Grade 1 pelvicalyceal ectasia was seen on ultrasound and grade 4-5 vesicoureteral reflux (VUR) was detected on the voiding cystourethrogram. The contrast-enhanced magnetic resonance imaging (MRI) study of the lumbar spine revealed expansion of the spinal cord due to peripherally enhancing lesions which extended for a distance of approximately 6.8 cm between L2 and S1. In the intradural space between the levels of L2 and S1 there was a heterogeneous T2 hyperintense lesion which expanded the spinal cord. The lesion was predominantly hypointense on the T1W sequence and demonstrated thick irregular peripheral enhancement on contrast-enhanced T1 images. Cauda equina fibers and leptomeninges also enhanced after contrast administration (Figures 1 A, B). Intradural tuberculosis abscess was diagnosed based on clinical and MRI findings. The abscess was drained surgically and a new antituberculosis therapy (rifampicin + clarithromycin + ethambutol) was started by pediatricians because of hepatotoxicity of previously given anti-TB drugs. After the therapy, follow-up imaging stud-

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Intramedullary Tuberculous Abscess

Abstract: The treatment of intramedullary abscess consists of surgical evacuation of the pus. Appropriate treatment offers a favorable prognosis even in cases with severe deficits.

Cited by 50 publications

References 20 publications

Atypical intradural spinal tuberculosis: report of three cases

Atypical intradural spinal tuberculosis: report of three cases

Conus intramedullary pyogenic abscess in a 4years old child: a rare case report and review of literature

Recurrent intradural spinal tuberculosis abscess in a child – follow-up magnetic resonance imaging

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