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A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients

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Published on: October 25, 2024

Typhoid osteomyelitis of the lumbar spine.

F Y Khan¹, A H El-Hiday, H A Kamel

¹Department of Medicine, Hamad General Hospital, Doha, Qatar. fakhanqal@yahoo.co.uk

Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi

|October 10, 2006

Summary

Spinal osteomyelitis caused by Salmonella typhi can present as fever and backache. Early diagnosis and treatment with antibiotics are crucial for recovery, as demonstrated in this case of a Nepali man.

Area of Science:

Infectious Diseases
Orthopedics
Radiology

Background:

Spinal osteomyelitis is a serious infection requiring prompt diagnosis and treatment.
Salmonella typhi is a common cause of enteric fever in endemic regions.
Back pain and fever are common but non-specific symptoms that can indicate spinal infection.

Observation:

A 25-year-old man presented with prolonged fever and lower backache.
MRI revealed inflammation and erosion of the L4-L5 vertebrae and intervertebral disc.
CT-guided aspiration identified Salmonella typhi infection.

Findings:

The patient was successfully treated with intravenous ampicillin for six weeks.
Complete resolution of symptoms and discharge were achieved.

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Salmonella typhi was sensitive to ampicillin, ciprofloxacin, and ceftriaxone.

Implications:

Typhoid osteomyelitis of the spine is a critical differential diagnosis in patients from endemic areas presenting with fever and back pain.
Prompt identification and targeted antibiotic therapy are essential for favorable outcomes.
This case highlights the importance of considering infectious etiologies in spinal pathologies.