An intramedullary spinal cord abscess and concurrent brain abscess caused by Klebsiella pneumoniae: a case report

Abstract Background Intramedullary spinal cord abscess (ISCA) is a rare infection of the central nervous system, particularly when it co-occurs with a brain abscess. Klebsiella pneumoniae, commonly causing pneumonia and urinary tract infections, can lead to severe infections in individuals with compromised immunity. Here, we present a rare case of an adult with cervical and thoracic ISCA along with a brain abscess, all caused by Klebsiella pneumoniae. Case presentation A middle-aged male was admitted to our hospital after experiencing fever, headache, neck pain and weakness in the left upper limb for two weeks. Successively diagnostic procedures included head and cervical spine MRI with diffusion- weighted imaging (DWI) and susceptibility-Weighted Imaging (SWI), as well as pus culture and cerebrospinal fluid (CSF) next-generation sequencing (NGS). The patient was diagnosed as an intramedullary spinal cord abscess (ISCA) and brain abscess infected by Klebsiella pneumonia. Treatment involved Meropenem for anti-infection and surgical intervention. Ultimately, the patient experienced reduced headache and significant improvement in left limb muscle strength post-surgery. Conclusion This case emphasizes the importance of early qualitative diagnosis and timely surgical interventions.