The patient’s single-view chest x-ray showed bilateral lung interstitial edema, left lung pulmonary parenchymal opacity, and left pleural effusion. A magnetic resonance imaging study of the cervical spine showed fluid collection from C2 through C5 that was indicative of an intramedullary cord abscess, with edema extending to the level of C7 (Fig. 1). Magnetic resonance imaging studies of the thoracic and lumbar spine were unremarkable. A magnetic resonance imaging study of the brain showed right frontal lobe subacute infarcts, most likely within the right anterior cerebral artery territory, likely due to the underlying condition of sickle cell disease, and mild caudal herniation of the cerebellar tonsils was observed. A computed tomographic study of the thorax showed bilateral lower lobe areas of atelectasis or consolidation, suggestive of pneumonia.Fig. 1Magnetic resonance imaging scan of the cervical spinal cord of the intramedullary abscess upon admission. This sagittal T2-weighted image shows an expansile intramedullary area of increased T2 signaling present in the spinal cord from C2 to C5