Intramedullary spinal cord
abscess in children is rare and holocord
abscess is rarer. An 18-month-old girl presented with rapidly progressive
paraplegia with
fever for 2 months. The patient had complete
flaccid paraplegia with absent sensation below D4 level. There was very small
dermal sinus discharging
pus in the lower lumbar region. Magnetic resonance imaging showed evidence of extensive multiloculated intramedullary
abscess extending from D4 to L5 with cord
edema upto cervical level.
Laminotomy, excision of the
dermal sinus and myelotomy, and evacuation of intramedullary
abscess was performed. Escherichia coli and Pseudomonas were grown on culture. The child was treated with long-term parenteral
antibiotics and started showing neurological improvement. Holocord
abscess secondary to congenital
dermal sinus is extremely rare and this is only the fourth report of such an instance.