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Spondylodiscitis extending to the right sacroiliac joint with subsequent development of amycotic pseudoaneurysm

Eushaa Mirza1, Jatin Naidu2, Vasanth Kumar Baskaradoss3

  • 1Radiology (East Midlands South Training Programme), Kettering General Hospital, Kettering, UK e.mirza@nhs.net.

BMJ Case Reports
|December 18, 2025
PubMed

Insights

This case study highlights a rare instance of disseminated Staphylococcus aureus infection causing spinal infections and a mycotic pseudoaneurysm in an elderly male. It emphasizes the diagnostic challenges and imaging findings associated with such severe S. aureus infections.

Area of Science:

  • Infectious Diseases
  • Radiology
  • Vascular Surgery

Background:

  • Disseminated spinal infections are typically associated with Mycobacterium tuberculosis.
  • Staphylococcus aureus is a common pathogen, but widespread musculoskeletal dissemination is rare.

Purpose of the Study:

  • To report a rare case of disseminated Staphylococcus aureus infection involving the spine and leading to a mycotic pseudoaneurysm.
  • To discuss the imaging findings and limitations of CT and MRI in diagnosing such complex infections.

Main Methods:

  • Case report of an elderly male patient.
  • Review of CT and MRI findings.
  • Discussion of treatment strategies for the infection and pseudoaneurysm.

Main Results:

  • The patient presented with spondylodiscitis, sacroiliitis, and associated collections due to Staphylococcus aureus.
  • A large mycotic pseudoaneurysm of the right internal iliac artery developed secondary to the infection.
  • Imaging demonstrated the extent of spinal and paraspinal involvement.

Conclusions:

  • Disseminated Staphylococcus aureus infections can manifest with severe spinal involvement and vascular complications like mycotic pseudoaneurysms.
  • Accurate and timely diagnosis using advanced imaging is crucial for effective management.
  • This case underscores the importance of considering S. aureus in disseminated infections, even when tuberculosis is more typical.
Keywords:
InfectionsOrthopaedicsRadiologyVascular surgery

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