Very few cases of intramedullary abscesses occur in healthy individuals [28, 50, 51]. Many of our cited examples were patients with specific underlying conditions that perhaps predisposed them to intramedullary abscess formation. Our patient had an underlying history of sickle cell disease, and we hypothesize that his underlying condition may have caused microvascular occlusive disease resulting in microinjury in the cord and allowing for the seeding and formation of the intramedullary abscess. A similar condition of vasoocclusion was described in a patient with spinal artery occlusion, likely arising from a bacterial embolic source, who then had an acute formation of an intramedullary abscess .