The patient was placed on cervical spine precautions. His blood cultures that were obtained from the outside hospital were found to have Streptococcus pneumoniae that was sensitive for ceftriaxone, which was empirically continued for a total duration of 1 month. Cultures from the syrinx and blood cultures obtained on admission did not have any growth. The patient was continued on intravenous antibiotics and steroids. He started to have improving mental status, sensation, and motor function. He underwent postoperative magnetic resonance imaging of the cervical spine 1 day after surgery, and the scans showed postsurgical drainage of the syrinx and laminectomy of C2-C6. Another magnetic resonance imaging study, obtained on postoperative day 8 (Fig. 2), showed slight improvement from the first postoperative study. The patient was extubated on postoperative day 5. At the end of his hospital stay, the patient did not have any signs or symptoms suggestive of sepsis. He had a decline in his white blood cell count as well as his procalcitonin level. He continued to experience decreased neurological function, with no sensation below the level of L2 and paresis of the bilateral lower extremities and left upper extremity. He had a nearly complete recovery of renal function after a trial of continuous renal replacement therapy. He was discharged to an inpatient spinal cord injury rehabilitation facility on postoperative day 12.Fig. 2Magnetic resonance imaging scan of the cervical spinal cord of the intramedullary abscess obtained 9 days postoperatively. This sagittal T2-weighted image shows stable postoperative changes after a myelotomy and laminectomy, as well as a persistent but stable T2-weighted hyperintensity starting from the level of C2 and extending down to the level of T1