Severe vertebral osteomyelitis in patients with spinal cord injury

Four patients with spinal cord injury (SCI) experienced severe and unusual clinical manifestations of vertebral osteomyelitis. The main feature of the illness was the development of extensive disease below the level of the SCI. Large paravertebral abscesses pointing to the skin developed in three patients. The fourth patient was seen initially with a persistent draining sinus on a previous nephrectomy incision site before the condition was diagnosed. All four patients underwent surgical debridement of infected bone together with antibiotic therapy. Vertebral osteomyelitis should be considered in patients with SCI and sepsis of uncertain origin.