Vertebral Osteomyelitis Secondary to a Retroperitoneal Abscess in an Adolescent Male: A Case Report

Area of Science:

• Infectious Diseases
• Orthopedics
• Radiology

Background:

• Pyogenic vertebral osteomyelitis (PVO) is a serious spinal infection, often originating from hematogenous seeding.
• Spondylodiscitis incidence is 2.4 per 100,000 person-years, increasing significantly in individuals over seventy.
• PVO is part of a broader category of spinal infections known as spondylodiscitis.

Observation:

• A previously healthy 14-year-old male presented with flank pain, back pain, and fever.
• The patient exhibited a rare manifestation of vertebral osteomyelitis linked to a large, retroperitoneal abscess of undetermined origin.
• Clinical presentation included symptoms suggestive of both spinal and abdominal pathology.

Findings:

• The case demonstrates vertebral osteomyelitis presenting atypically in an adolescent patient.
• A significant retroperitoneal abscess was identified as a concurrent condition.
• Antibiotic treatment yielded positive short-term outcomes for the patient.

Implications:

• Vertebral osteomyelitis in pediatric patients may manifest with flank or back pain, necessitating thorough evaluation.
• This case underscores the potential for PVO to present as an extraperitoneal sign of a retroperitoneal abscess.
• Recognizing rare presentations is crucial for timely diagnosis and effective management of spinal infections in adolescents.