Spinal epidural abscess with diskitis-osteomyelitis and facet joint septic arthritis

Case contributed by Dr Appukutty Manickam


A 70 year old male, without immunosuppression, presented with severe thoracic back pain and fulminant septicemia.

Patient Data

Age: 70 years
Gender: Male

T1-weighted post-gadolinium sagittal MRI of full spine on admission.  A pan-regional (i.e. cervico-thoraco-lumbo-sacral [CTLS]) spinal epidural abscess (SEA) is demonstrated.  Focal SEA distort the thecal sac and cause mild canal stenosis but without cord signal change. Diskitis with vertebral body osetomyelitis is present at C5/C6, T4/T5, T8/T9; diskitis alone at L3/L4 and L5/S1; and left L5/S1 facet joint septic arthritis.

Case Discussion

CT and MRI revealed a total CTLS SEA associated with multi-level diskitis, vertebral body osteomyelitis and facet joint septic arthritis.  Blood cultures grew Staph. aureus sensitive to flucloxacillin and rifampin. 

PlayAdd to Share

Case information

rID: 56669
Published: 29th Nov 2017
Last edited: 14th Aug 2019
Inclusion in quiz mode: Excluded
Institution: St George Hospital

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.