Chronic spinal cord abscess in an elderly patient.

BACKGROUND: Spinal cord abscesses are rare. Acute lesions may present as spinal cord syndrome with back pain and fever, whereas chronic abscesses tend to have a less specific symptomatology, especially in elderly patients.

METHODS: Case report and review of the pertinent literature.

CASE REPORT: An 82-year old male with diabetes mellitus presented with a four-month history of backache and some difficulty walking without sphincter disturbance or fever. Spinal magnetic resonance imaging revealed a midthoracic intramedullary ring-like lesion that proved to be an abscess. Corticosteroids, gentamicin, and ciprofloxacin were given. The abscess resolved after three months.

CONCLUSIONS: Classically, treatment of intramedullary abscesses involves surgical drainage of the abscess cavity and administration of appropriate antibiotics, although medical therapy alone may be appropriate in some cases. If the diagnosis is unclear or patients do not respond to medical management, surgical decompression should be performed.