Chan C T, Gold W L
Division of General Internal Medicine, Toronto Hospital, University of Toronto, Ontario, Canada.
Clin Infect Dis. 1998 Sep;27(3):619-26. doi: 10.1086/514699.
We review the clinical features, microbial etiologies, mechanisms of infection, and outcomes of 25 cases of intramedullary abscess of the spinal cord (IASC) reported between 1977 and 1997, the modern era. All patients presented with motor and/or sensory neurological deficits. Back pain and/or radicular pain was common (60%); fever was present in a minority (40%) of patients. Preexisting abnormalities of the spinal cord and/or vertebral column were present in 44% of cases. Contiguous spread of infection through a congenital dermal sinus was the mechanism of infection in 24% of cases. The infection was fatal in 8% of cases; persistent neurological deficits were documented in 70% of patients who survived. To assess the impact of antimicrobial therapy on the pathogenesis and outcomes of IASC, cases reported in the modern era are compared with 42 cases of IASC reported between 1830 and 1944, the preantibiotic era.
我们回顾了现代时期（1977年至1997年）报告的25例脊髓髓内脓肿（IASC）的临床特征、微生物病因、感染机制及转归。所有患者均有运动和/或感觉神经功能缺损。背痛和/或神经根性疼痛较为常见（60%）；少数患者（40%）有发热。44%的病例存在脊髓和/或脊柱的既往异常。24%的病例感染机制为通过先天性皮窦的感染蔓延。8%的病例感染是致命的；70%存活患者有持续性神经功能缺损记录。为评估抗菌治疗对IASC发病机制和转归的影响，将现代时期报告的病例与抗生素前时代（1830年至1944年）报告的42例IASC病例进行了比较。
