Spinal infection with accompanying epidural and psoas muscle abscess
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Previously healthy female with 3-day history of lower back pain radiating down right leg and fever on the day of presentation
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MRI lumbar spine pre- and post-contrast revealed evidence of epidural collection medially and posteriorly secondary to L3/L4 septic arthritis, inflammatory changes because of facet septic arthritis are significant.
There is also enlargement of the iliopsoas muscle noted along with a collection within the muscle. This collection is partially organized. Inflammatory changes are noted around the exiting nerve root at L3/4 and L4/5 levels. Enhancement of dura also noted in keeping with inflammatory changes
The patient was taken to the theater by the orthopedic team for an urgent sampling of psoas muscle abscess.
Psoas abscess biopsy: Staph aureus (pan-sensitive)
The patient was ultimately treated successfully with IV antibiotics with clinical and radiological resolution.
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