[Staphylococcal spondylitis--cause of a recurrent fever for 24 years]

A 72-year-old man had had recurrent fever of undetermined cause, for which he had repeated periods in hospital. There were no specific organ-related symptoms. Conventional radiology of the vertebrae, tomography, CT scan and CT-guided needle biopsy finally revealed the presence of staphylococcal spondylitis of thoracic vertebrae 11 and 12 with bilateral paravertebral abscesses. Particularly valuable diagnostically was the CT scan with demonstration of bony destruction in the axial plane and of the paravertebral soft-tissue changes, as well as the use of CT-assisted puncture of the abscess. Asymptomatic spondylitis should be thought of as a possible cause of pyrexia of unknown origin.