Case Report: A rare case of intramedullary spinal cord abscess with brain abscess caused by Klebsiella pneumoniae underwent surgical intervention

Intramedullary Spinal Cord Abscess (ISCA) is an uncommon infectious disease of the central nervous system. Since its first report in 1830, there have been very few documented cases associated with it. Here, we present a case of ISCA with cerebral abscess caused by Klebsiella pneumoniae. A 55-year-ol...

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Published inFrontiers in surgery Vol. 11; p. 1338719
Main Authors Zhang, Wenjuan, Guo, Xiangyu, Xu, Xuejun, Deng, Bing
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 27.02.2024
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Summary:Intramedullary Spinal Cord Abscess (ISCA) is an uncommon infectious disease of the central nervous system. Since its first report in 1830, there have been very few documented cases associated with it. Here, we present a case of ISCA with cerebral abscess caused by Klebsiella pneumoniae. A 55-year-old male patient presented with head and neck pain, fever, and left limb weakness for 5 days. The diagnosis of ISCA with brain abscess caused by Klebsiella pneumoniae was confirmed through sputum culture, cerebrospinal fluid gene test, pus culture, and magnetic resonance imaging (MRI) as well as computerized tomography (CT) scan. The patient had a history of pulmonary tuberculosis and old tuberculous foci were observed in the lung. Initially considering tuberculosis as the cause due to unclear etiology at that time, anti-tuberculosis treatment was administered. However, due to rapid deterioration in the patient's condition and severe neurological dysfunction within a short period of time after admission, surgical intervention including incision and drainage for intramedullary abscess along with removal of brain abscess was performed. Subsequent postoperative follow-up showed improvement in both symptoms and imaging findings. Early diagnosis of central nervous system (CNS) abscess coupled with prompt surgical intervention and administration of appropriate antibiotics are crucial factors in preventing disease progression and reducing mortality rates.
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George Fotakopoulos, University Hospital of Larissa, Greece
Reviewed by: Nicolo Norri, University of Ferrara, Italy
Edited by: Antonino Raco, Sapienza University of Rome, Italy
Abbreviations ISCA, intramedullary spinal cord abscess; MRI, magnetic resonance imaging; CT, computerized tomography; CNS, central nervous system; T1WI, T1-weighted imaging; T2WI, T2-weighted imaging; CSF, cerebrospinal fluid; WBC, white blood cell; mNGS, metagenomic next-generation sequencing.
ISSN:2296-875X
2296-875X
DOI:10.3389/fsurg.2024.1338719