Journal Article

Intramedullary Abscess of the Spinal Cord in the Antibiotic Era: Clinical Features, Microbial Etiologies, Trends in Pathogenesis, and Outcomes

Christopher T. Chan and Wayne L. Gold

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 3, pages 619-626
Published in print September 1998 | ISSN: 1058-4838
Published online September 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514699
Intramedullary Abscess of the Spinal Cord in the Antibiotic Era: Clinical Features, Microbial Etiologies, Trends in Pathogenesis, and Outcomes

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We review the clinical features, microbial etiologies, mechanisms of infection, and outcomes of 25 cases of intramedullary abscess of the spinal cord (IASC) reported between 1977 and 1997, the modern era. All patients presented with motor and/or sensory neurological deficits. Back pain and/or radicular pain was common (60%); fever was present in a minority (40%) of patients. Preexisting abnormalities of the spinal cord and/or vertebral column were present in 44% of cases. Contiguous spread of infection through a congenital dermal sinus was the mechanism of infection in 24% of cases. The infection was fatal in 8% of cases; persistent neurological deficits were documented in 70% of patients who survived. To assess the impact of antimicrobial therapy on the pathogenesis and outcomes of IASC, cases reported in the modern era are compared with 42 cases of IASC reported between 1830 and 1944, the preantibiotic era.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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