A 70-year-old female with diabetes well controlled on insulin, prior cervical fusion, not on immunosuppressant medications, was admitted for neck pain and left arm weakness. One month before she was admitted for watery diarrhea and treated with ciprofloxacin without any neurological abnormality. This time, she came with severe left upper extremity weakness and sensory loss, no spinal tenderness. MRI imaging shows diffuse cervical cord edema and rim-like enhancement from C4–T1. CSF shows lymphocytic pleocytosis with elevated protein. Cultures and PCR were negative as well as pathology for malignant cells. The patient continued to have worsening left upper extremity pain and weakness despite being treated with dexamethasone injection. Autoimmune myelitis, lymphoma, and infection are three possible differential diagnoses. Biopsy is favored due to deterioration of the patients.