Considering our patient’s presentation, it is also not known if he developed the intramedullary abscess before or after the onset of meningitis. A few cases have been reported that showed concurrent meningitis and intramedullary abscess formation [18, 53–55]. The authors of one report described the concurrent presentation of cervical spinal cord abscess, brain abscess, and meningitis . One patient, 7 years old, had recurrent meningitis, which was a manifestation of a chronic intramedullary abscess that likely continuously seeded the intrathecal space . A similar mechanism was seen in a 63-year-old patient . The authors of one paper did report the development of acute meningitis after a rupture of a chronic intramedullary abscess .