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Intramedullary tubercular abscess with syrinx formation.

Khalid M, Khalid S, Mittal S, Ahmad U - J Pediatr Neurosci (2012)

Bottom Line: Intramedullary spinal cord tubercular abscess with involvement of whole cord is a rare entity that too with syrinx formation following disseminated meningitis.Accurate diagnosis requires a high index of suspicion with clinical history and imaging features for a favorable outcome.Here-in we present a similar case with tubercular etiology which was also associated with syrinx formation and has not been reported previously in the literature up to the author's knowledge.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiodiagnosis, J N Medical College, AMU, Aligarh, Uttar Pradesh, India.

ABSTRACT
Intramedullary spinal cord tubercular abscess with involvement of whole cord is a rare entity that too with syrinx formation following disseminated meningitis. Accurate diagnosis requires a high index of suspicion with clinical history and imaging features for a favorable outcome. Here-in we present a similar case with tubercular etiology which was also associated with syrinx formation and has not been reported previously in the literature up to the author's knowledge.

No MeSH data available.


Related in: MedlinePlus

H and E stain shows characteristic tubercular lesion depicting epithelioid cell granulomas along with Langhans giant cell surrounded by rim of lymphocytes and central focal necrosis (40×)
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Figure 3: H and E stain shows characteristic tubercular lesion depicting epithelioid cell granulomas along with Langhans giant cell surrounded by rim of lymphocytes and central focal necrosis (40×)

Mentions: Following MRI, the patient underwent surgery for drainage and confirmation of the etiology. Partial laminectomy was performed and through a midline myelotomy intramedullary abscess was drained. The spinal cord which was distended became lax after the surgical procedure. The necrotic pus-like tissue collected was sent for culture and histopathological examination. Histopathological examination showed the presence of chronic inflammatory cells with caseating epithelioid cell granuloma and ZN staining was also performed on sections which showed AFB positive bacilli [Figures 4 and 5]. Culture showed acid fast bacilli confirming tubercular nature of the lesion. Postoperative recovery was uneventful with rapid improvement of clinical symptoms and the patient was discharged with ATT with an advice for regular follow-up.


Intramedullary tubercular abscess with syrinx formation.

Khalid M, Khalid S, Mittal S, Ahmad U - J Pediatr Neurosci (2012)

H and E stain shows characteristic tubercular lesion depicting epithelioid cell granulomas along with Langhans giant cell surrounded by rim of lymphocytes and central focal necrosis (40×)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3401660&req=5

Figure 3: H and E stain shows characteristic tubercular lesion depicting epithelioid cell granulomas along with Langhans giant cell surrounded by rim of lymphocytes and central focal necrosis (40×)
Mentions: Following MRI, the patient underwent surgery for drainage and confirmation of the etiology. Partial laminectomy was performed and through a midline myelotomy intramedullary abscess was drained. The spinal cord which was distended became lax after the surgical procedure. The necrotic pus-like tissue collected was sent for culture and histopathological examination. Histopathological examination showed the presence of chronic inflammatory cells with caseating epithelioid cell granuloma and ZN staining was also performed on sections which showed AFB positive bacilli [Figures 4 and 5]. Culture showed acid fast bacilli confirming tubercular nature of the lesion. Postoperative recovery was uneventful with rapid improvement of clinical symptoms and the patient was discharged with ATT with an advice for regular follow-up.

Bottom Line: Intramedullary spinal cord tubercular abscess with involvement of whole cord is a rare entity that too with syrinx formation following disseminated meningitis.Accurate diagnosis requires a high index of suspicion with clinical history and imaging features for a favorable outcome.Here-in we present a similar case with tubercular etiology which was also associated with syrinx formation and has not been reported previously in the literature up to the author's knowledge.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiodiagnosis, J N Medical College, AMU, Aligarh, Uttar Pradesh, India.

ABSTRACT
Intramedullary spinal cord tubercular abscess with involvement of whole cord is a rare entity that too with syrinx formation following disseminated meningitis. Accurate diagnosis requires a high index of suspicion with clinical history and imaging features for a favorable outcome. Here-in we present a similar case with tubercular etiology which was also associated with syrinx formation and has not been reported previously in the literature up to the author's knowledge.

No MeSH data available.


Related in: MedlinePlus