title: Intramedullary abscess of the spinal cord in the setting of patent foramen ovale.
abstract: BACKGROUND
  Intramedullary abscess of the spinal cord is a rare entity, especially in the setting of an intracardiac shunt, which, to our knowledge, has not been described in the literature. Here we present a case of an intramedullary spinal cord abscess in a patient with a patent foramen ovale.
  
  
  METHODS
  The article includes a chart review and description of a clinical case presentation.
  
  
  RESULTS
  A 59-year-old man was admitted with rapidly progressive quadriparesis. Magnetic resonance imaging of the cervical spine demonstrated a large intramedullary mass extending from the level of C3 to C7. The patient was taken to the operating room for biopsy and surgical evacuation of the mass. Intraoperative pathology was consistent with abscess, and subsequent cultures grew Streptococcus viridans. On further workup, the patient was found to have a patent foramen ovale with right-to-left flow. Postoperatively, the strength improved significantly in all extremities with residual weakness.
  
  
  CONCLUSIONS
  This is the first published case of an intramedullary spinal cord abscess in the setting of an intracardiac right-to-left shunt. Although intramedullary spinal cord abscess is rare, there are certain predisposing conditions that increase the risk of its occurrence.
authors: Department of Neurological Surgery, University of Southern California, Keck School of Medicine, Los Angeles, California, USA. sterterov@mednet.ucla.edu
authors: Sergei
authors: S
authors: Terterov
authors: Alexander
authors: A
authors: Taghva
authors: Alexander A
authors: AA
authors: Khalessi
authors: Paul E
authors: PE
authors: Kim
authors: Charles
authors: C
authors: Liu
mesh_terms: D000038:Abscess / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007958:Leukocyte Count; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011782:Quadriplegia / Q000209:etiology; D013118:Spinal Cord Diseases / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D013290:Streptococcal Infections / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D016306:Vena Cava Filters; D034363:Viridans Streptococci
chemical_list: D000900:Anti-Bacterial Agents