Spinal Intramedullary Tubercular Abscess

Spinal intramedullary tubercular abscess are extremely rare. We present here a 3 yrs young boy, with subacute paraparesis following fever, and incontinence for one day. His MRI showed a contrast ring enhancing intramedullary SOL at D10- D12 with central T1 hypointense, T2 hyperintense core and cord expansion and a central syrinx above. He underwent laminectomy, evacuation of abscess, with ATT and steroids postoperatively. There was pus evacuated intraop, showed positive AFB bacilli, and the wall biopsy showed inflammatory cell infiltrate and no giant cell or granuloma formation. Child improved well and discharged well. Thus presenting worlds probably first case of a rare Intramedullary Spinal TB abscess satisfying all Whitener's criteria in the available literature.