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Case Report | Pathology | Volume 15 Issue 6, June 2026 | Pages: 1292 - 1294 | India
Worm in the Spine: Cytological Evaluation of a Rare Spinal Abscess
Abstract: Neuroparasitic infections are uncommon causes of neurological disease and rarely present with spinal cord involvement resulting in acute paraplegia. We report a rare case of a 33-year-old male who presented with severe lower back pain, rapidly progressive paraplegia, and loss of bowel and bladder sensation. Radiological findings suggested an infective spinal pathology, clinically favoring tuberculosis. During surgical management of L5 spondylolisthesis and disc bulge, an unexpected spinal abscess was encountered. Cytological examination of the aspirated pus revealed multiple elongated larval forms within a dense neutrophil-rich inflammatory background, establishing an incidental diagnosis of neuroparasitic infection. Notably, peripheral blood and cerebrospinal fluid analyses showed no eosinophilia, highlighting a diagnostic pitfall. Morphological assessment was best achieved on Papanicolaou-stained smears, which demonstrated superior visualization of larval morphology, segmentation, and surrounding clear spaces compared with other routine stains. This case emphasizes that parasitic infections should remain a differential diagnosis in patients presenting with acute paraplegia, even in the absence of eosinophilia, and underscores the important diagnostic role of cytological examination and Pap staining in identifying parasitic larvae.
Keywords: Spinal abscess, Cytology, Angiostrongylus Cantonensis, Toxocara Canis, and Trichinella Spiralis
How to Cite?: Dr. Bhaumik D. Patel, Shantanu S. Parikh, Dr. Yogita Kareliya, Dr. Swati Patel, Dr. Arpita Shah, "Worm in the Spine: Cytological Evaluation of a Rare Spinal Abscess", Volume 15 Issue 6, June 2026, International Journal of Science and Research (IJSR), Pages: 1292-1294, https://www.ijsr.net/getabstract.php?paperid=SR26624152955, DOI: https://dx.doi.org/10.21275/SR26624152955