title: Intramedullary Tuberculoma Combined with Abscess: Case Report and Literature Review.
abstract: BACKGROUND
  Intramedullary spinal tuberculoma combined with abscess has low incidence and could easily be misdiagnosed. Given the rarity of spinal intramedullary tuberculoma, there is no standardized treatment protocol for this condition. We reported the case of a 28-year-old male who was diagnosed with intramedullary tuberculoma combined with abscess and treated with antituberculosis therapy followed by surgery.
  
  
  METHODS
  A 28-year-old male was admitted to our hospital with lower back pain and lower limb sensory and motor dysfunction. The radiographic results indicated tuberculosis (TB). The patient was suggested to undergo anti-TB therapy and was later transferred to Tuberculosis Hospital for systemic treatment for 20 days. He was readmitted to our hospital because of aggravating syndromes including impaired superficial sensation below the T11 level, spastic paresis with muscle strength of 0/5 in both lower extremities, and exaggerated bilateral tendon reflexes. To alleviate the neurologic dysfunction, surgery was undertaken. The postoperative diagnosis was thoracic intramedullary TB combined with abscess. He reported marked improvement in lower limb motor and sensory function the day after surgery, and his muscle strength recovered to 3/5.
  
  
  CONCLUSIONS
  Although intramedullary TB combined with abscess is clinically rare, it should be taken into consideration when patients present with intramedullary space-occupying lesions with TB lesions elsewhere. Most patients respond well to the anti-TB therapy, but for those with severe spinal cord compression or those irresponsive to the drug therapy, surgical intervention could facilitate neurologic recovery and improve the prognosis.
authors.affiliation: Department of Spine Surgery, Xi'an Jiaotong University Health Science Center, Honghui Hospital, Xi'an City, Shanxi Province, China.
authors.forename: Jijun
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Spine Surgery, Xi'an Jiaotong University Health Science Center, Honghui Hospital, Xi'an City, Shanxi Province, China.
authors.forename: Haiping
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Spine Surgery, Xi'an Jiaotong University Health Science Center, Honghui Hospital, Xi'an City, Shanxi Province, China.
authors.forename: Baorong
authors.initials: B
authors.lastname: He
authors.affiliation: Department of Spine Surgery, Xi'an Jiaotong University Health Science Center, Honghui Hospital, Xi'an City, Shanxi Province, China.
authors.forename: Biao
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Spine Surgery, Xi'an Jiaotong University Health Science Center, Honghui Hospital, Xi'an City, Shanxi Province, China.
authors.forename: Xingbang
authors.initials: X
authors.lastname: Niu
authors.affiliation: Department of Spine Surgery, Xi'an Jiaotong University Health Science Center, Honghui Hospital, Xi'an City, Shanxi Province, China. Electronic address: haodingjundr@163.com.
authors.forename: Dingjun
authors.initials: D
authors.lastname: Hao
mesh_terms: D000038:Abscess / Q000150:complications* / Q000601:surgery; D000328:Adult; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed; D014375:Tuberculoma / Q000150:complications* / Q000473:pathology* / Q000601:surgery
keywords: Abscess; Diagnosis; Intramedullary tuberculoma; Treatment