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Background: Although tuberculosis is rare in the west, in recent years, it's becoming more and more common in China. Intraspinal tuberculoma is extremely rare, but it's an important cause of morbidity. Magnetic resonance imaging scanning is an effective method for the diagnosis of intraspinal tuberculoma., Case Description: This case report shows an intraspinal tuberculoma with giant paraspinal abscesses in a 28-year-old female patient with subacute progressing neurologic deficit. L1-L5 laminectomy was performed, followed by extensively excision of intraspinal and paraspinal lesion. Antituberculous treatment was carried out after pathologic diagnosis. An excellent clinical outcome was obtained. Within 24 hours of the surgical procedure, muscle weakness in both lower extremities started to improve. Three days later, the patient felt muscle strength recovered significantly, with grade 4/5 in the lower limbs in 2 weeks. Six weeks later, the patient was able to walk without assistance., Conclusions: The case was treated by surgical excision of an intraspinal and a paraspinal lesion followed by normal quadruple antituberculous therapy. Although intraspinal tuberculoma is a rare entity, it can be effectively diagnosed on the basis of magnetic resonance imaging scanning and treated by the combination of medical and surgical treatments., (Copyright © 2019 Elsevier Inc. All rights reserved.)

A 68-year-old male presented with rapidly progressive paraplegia. MR images of the thoracic spine were interpreted as being consistent with an abscess within an epidural lipomatosis compressing the spinal cord. Laminectomy was performed, and a large amount of pus was drained from the epidural lipomatosis, from which Staphylococcus aureus was isolated. This is the first reported case of an abscess involving an epidural lipomatosis.

An unusual case of metastatic paraspinal abscess and paraplegia is presented. This was a consequence of simple dental extractions and subsequent bacteraemia from a neglected mouth. Neurosurgical intervention and tissue culture yielded organisms almost certainly of dental origin. No alternative primary nidus of infection could be found. The importance of oral health to general health is emphasised.

A 36-year-old woman with gallbladder disease had an incidental finding of asymptomatic cavitary lung infection with Blastomyces dermatitidis. No treatment was given initially, and 2 months later she presented with vertebral osteomyelitis, paraspinal abscess, and spinal cord compression due to dissemination of the fungus. The patient recovered following surgical debridement and treatment with 1 g of amphotericin B, followed by itraconazole 400 mg QD for 6 months. In spite of previous reports of the self limiting nature of primary pulmonary blastomycosis in the normal host, antifungal therapy may be needed in cases that do not resolve spontaneously within a short period of time, or if transient immunosuppression may be anticipated as may occur following surgery or after acquisition of other infections.

An epidural abscess caused by Aspergillus fumigatus occurred in a recipient of a cadaveric, renal allograft. The patient had persistent back pain and a peripheral neuropathy that involved the lower extremities. Signs of spinal cord compression evolved. No definite portal of entry was found. Diagnosis was made by histologic examination and culture of a biopsy specimen. Therapy, consisting of aggressive surgical debridement, intravenous amphotericin B, and oral flucytosine was unsuccessful in eradicating the organism. At postmortem examination, Aspergillus was identified at the abscess site. To our knowledge, aspergillosis presenting as an epidural abscess in the immunosuppressed, renal transplant recipient has not previously been reported and should be considered in the differential diagnosis of back pain and peripheral neuropathy in such a patient.