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Background: Intramedullary abscesses are rare infections of the spinal cord. Intramedullary abscesses often have a complex presentation, making a high index of suspicion essential for prompt diagnosis and management.
Case Presentation: We present two cases of intramedullary abscesses referred to and ultimately managed at our institution. Delayed diagnosis occurred in both instances due to the rarity of intramedullary abscesses and their propensity to mimic other pathologies. For both patients, prompt surgical management and the rapid institution of broad-spectrum antibiotics were critical in preventing further neurological decline.
Conclusions: Although rare, it is critical to consider intramedullary abscesses on the differential for any MRI lesions that are hyperintense on T2 and peripherally enhancing on T1 post-contrast sequences, as even short delays in treatment can lead to severe neurological damage.
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http://dx.doi.org/10.1186/s12879-022-07099-7 | DOI Listing |
Arthrosc Tech
July 2025
Department of Orthopaedics and Traumatology, Tuen Mun Hospital, Hong Kong SAR, China.
Chronic osteomyelitis occurs if the bone infection persists for more than 6 weeks. The presence of dead bone (sequestrum) and intramedullary abscess with chronic infected tissue may protect bacteria from the endogenous host immune response and limit the effectiveness of many antibiotics. Classically, removal of infected tissue inside the medullary cavity requires extensive osteotomy to create a bone window of adequate size.
View Article and Find Full Text PDFArthrosc Tech
July 2025
Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, NT, Hong Kong SAR, China.
Chronic osteomyelitis is characterized by the presence of asequestrum, intramedullary abscess, and fistulous tracts. Bone endoscopy provides a minimally invasive approach to drain the intramedullary abscess and remove the dead and infected tissues under direct endoscopic visualization. The purpose of this Technical Note is to describe the details of uniportal endoscopic intramedullary debridement for management of chronic osteomyelitis of the metaphyseal region of tibia.
View Article and Find Full Text PDFJ Orthop Case Rep
August 2025
Department of Orthopedic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Introduction: Clavicle fractures are common injuries and the trend from non-operative management has been now changed toward operative management. Plate fixation after open reduction and intramedullary nail fixation after closed reduction are the standard operative management techniques. Nail fixation although has advantages of being minimally invasive, it has its own complications.
View Article and Find Full Text PDFJMA J
July 2025
Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan.
Intramedullary spinal cord abscesses rarely cause impaired consciousness without intracranial infection. We report the case of a 65-year-old woman who presented with neck pain and right upper limb weakness. She developed rapidly progressive impaired consciousness within three days of admission.
View Article and Find Full Text PDFJ Clin Med
July 2025
Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany.
Osteomyelitis, particularly affecting the lower extremities, is a serious and increasingly common complication. Accurate diagnosis is essential for successful treatment, yet standardized evidence-based protocols are lacking and diagnostic knowledge remains limited. This study aimed to identify characteristic histological and MRI findings in osteomyelitis to support diagnostic accuracy and guide treatment decisions.
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