Long-Term Outcomes of Conservative Management for Pyogenic Myelitis

Authors

  • Fahad Badr Albadr, MD Department of Radiology and Medical Imaging, King Saud University Medical City. College of Medicine, King Saud University, Riyadh
  • Renad Mohammed Alotibi Medical Intern, King Saud University, Riyadh
  • Abdullah Abdulaziz Albakri Department of Diagnostic Radiology, King Khalid University Hospital, Riyadh
  • Nourah Rsheed Alrsheed 4Department of Pediatrics, Maternity and Children Hospital, Buraydah
  • Lama Akram Alanazi Medical Intern, University of Tabuk. Tabuk

DOI:

https://doi.org/10.3941/jrcr.6030

Abstract

Intramedullary spinal cord abscesses are uncommon, with only a few documented cases. They typically present with lower-limb neurological symptoms and signs of sepsis, often leading to misdiagnosis, particularly in children, where symptoms may be atypical. The present case report details the distinctive presentation of a 4-year-old boy with recurrent urinary tract infections who subsequently developed lower-limb weakness. Initially, his symptoms were attributed to recurrent urinary tract infections, delaying neurological evaluation. However, magnetic resonance imaging revealed a diffuse intramedullary spinal cord abscess extending from the cervical to lumbar regions, linked to an S2–S3 congenital dermal sinus tract. These uncommon congenital dermal sinus tracts promote infections, often leading to overlooked abscess formation in children. Magnetic resonance imaging confirmed whole-spine involvement and follow-up imaging revealed significant resolution with residual fibrotic changes.

A 4-year-old boy with recurrent urinary tract infections who subsequently experienced lower-limb weakness due to pyogenic myelitis secondary to congenital dermal sinus.

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Published

2026-01-31

Issue

Vol. 20 No. 1 (2026)

Section

Neuroradiology

License

Copyright (c) 2026 Journal of Radiology Case Reports

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