title: Streptococcus pneumoniae meningitis complicated by an intramedullary abscess: a case report and review of the literature.
abstract: BACKGROUND
  Intramedullary abscess is a rare neurosurgical condition that usually arises in the setting of penetrating trauma to the spinal cord, infected congenital dural sinuses, or tuberculosis.
  
  
  METHODS
  We describe a case of a 35-year-old African American male who presented with sepsis and a clinical picture of meningitis. The patient continued to have declining neurological status with decreasing sensation and worsening motor strength in all four extremities. He was found to have an intramedullary abscess in the cervical spinal cord that was treated with a decompressive posterior cervical laminectomy and drainage. The patient began to have a partial recovery of neurological function postoperatively. We also review the literature on intramedullary abscess that suggests the clinical presentation of our patient was a rare complication of acute meningitis.
  
  
  CONCLUSIONS
  Intramedullary abscess formation is a rare entity, and a high index of suspicion for intramedullary abscess is the key for making the diagnosis and expediting treatment for these patients.
authors.affiliation: Department of Pediatrics, John Peter Smith Hospital, 1500 South Main Street, Fort Worth, TX, 76104, USA. dat.vo@utsouthwestern.edu.|Department of Neurosurgery, John Peter Smith Hospital, 1500 South Main Street, Fort Worth, TX, 76104, USA. dat.vo@utsouthwestern.edu.|The Center for Neurological Disorders, 1010 Houston Street, Fort Worth, TX, 76102, USA. dat.vo@utsouthwestern.edu.|Department of Radiation Oncology, The University of Texas Southwestern Medical Center, 5801 Forest Park Road, Dallas, TX, 75390, USA. dat.vo@utsouthwestern.edu.
authors.forename: Dat T
authors.initials: DT
authors.lastname: Vo
authors.affiliation: Department of Neurosurgery, John Peter Smith Hospital, 1500 South Main Street, Fort Worth, TX, 76104, USA.|The Center for Neurological Disorders, 1010 Houston Street, Fort Worth, TX, 76102, USA.
authors.forename: George F
authors.initials: GF
authors.lastname: Cravens
authors.affiliation: Department of Neurosurgery, John Peter Smith Hospital, 1500 South Main Street, Fort Worth, TX, 76104, USA.|The Center for Neurological Disorders, 1010 Houston Street, Fort Worth, TX, 76102, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Germann
mesh_terms: D000038:Abscess / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D000328:Adult; D066193:Cervical Cord / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008586:Meningitis, Pneumococcal / Q000134:cerebrospinal fluid / Q000150:complications*; D018805:Sepsis / Q000382:microbiology; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000382:microbiology* / Q000601:surgery; D013290:Streptococcal Infections / Q000150:complications* / Q000175:diagnosis
keywords: Case report; Infected syrinx; Intramedullary abscess; Laminectomy; Meningitis; Myelotomy