Spinal intramedullary tubercular abscess is an extremely rare entity. Only few cases are reported in published literature.
A 30-year-old female with known case of pulmonary tuberculosis taking antitubercular treatment (ATT) for the last 6 months presented with back pain and progressive paraparesis. Her magnetic resonance imaging (MRI) dorsolumbar spine was suggestive of intramedullary abscess at D3 to D7 vertebrae level; she underwent D2 to D7 laminectomy and evacuation of pus and, subsequently, acid-fast bacilli (AFB) staining and pus culture. Mycobacterium tuberculosis was seen in both staining and culture of pus. Patient had shown signs of improvement and was discharged on 7th postoperative day.
In tuberculosis abscess, if the patient does not respond to medical management, and if progressive neurological deficit is present, surgery should be done for a definite histological diagnosis and decompression.
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