SPINAL ABSCESSES IN PURULENT-MENINGITIS

Spinal abscesses are usually easily detected by clinical examination, CSF testing, and radiological imaging techniques. Diagnosis can be obs cured in cases presenting with purulent meningitis, sepsis, and impair ed consciousness. We describe 7 cases in which purulent meningitis ini tially dominated the clinical appearance. In 3 cases each, staphylococ ci or streptococci were cultured; one case was due to M. tuberculosis infection. Only after improvement of the obscured consciousness the pa raparesis became more obvious, and the spinal abscesses were diagnosed . Four patients recovered favourably after decompression operations wh ereas 3 patients with rapid deterioration could not be operated on and died subsequently. In patients with purulent meningitis, any sign of ensuing paraparesis should prompt immediate magnetic resonance examina tion of the spinal canal to enable early detection of a spinal abscess . Immediate neurosurgical intervention determines the outcome.