Introduction

Intramedullary spinal cord abscesses (ISCA) are rare and caused by central nervous system infections. Although polymicrobial infections are rarely seen in ISCAs, isolation of the causative pathogen is important for treatment. Here, we describe a very rare case of ISCA resulting from a mixed Streptococcus and Actinomyces infection.

Case presentation

An 82-year-old man presented with acute posterior cervical pain and progressive quadriplegia. Radiological investigations revealed a mass lesion showing marginal enhancement at the level of the C3-4 vertebrae. Microsurgical drainage was performed, and Streptococcus and Actinomyces were identified as causative agents. Subsequent antibiotic treatment was noted to be beneficial to the patient.

Discussion

This case suggests that mixed infection can develop into ISCA depending on the causative agents such as Actinomyces. Prompt pathogen-directed antibacterial therapy is required for ISCA treatment.

中文翻译：

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放线菌和链球菌引起的髓内脊髓脓肿一例报告并文献复习

介绍

髓内脊髓脓肿（ISCA）很少见，由中枢神经系统感染引起。尽管多种微生物感染在 ISCA 中很少见，但分离致病病原体对于治疗很重要。在这里，我们描述了一个非常罕见的由链球菌和放线菌混合感染引起的 ISCA 病例。

案例展示

一名 82 岁男性因急性颈后痛和进行性四肢瘫痪就诊。放射学检查显示 C3-4 椎骨水平存在肿块病变，边缘增强。进行显微外科引流，并确定链球菌和放线菌为病原体。随后的抗生素治疗被认为对患者有益。

讨论

本病例表明，混合感染可根据放线菌等病原体而发展为ISCA 。ISCA 治疗需要及时针对病原体的抗菌治疗。