Table 3.
Summary of clinical details, image studies, surgical methods and outcome of six patients with spontaneous infective spondylitis and mycotic aneurysm
| Case no. | Age (years)/sex | Underlying diseases | Clinical symptoms | Symptom duration | WBC count (mm3) | Lesion site | Radiography | CT or MRI | Pathogen | Surgical methodsb | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 60/M | Diabetic mellitus | Back pain with fever | 8 weeks | 8,100 | T12–L1 | Endplate destruction (+) Vertebral body collapse (+) |
Prevertebral mass (+) left psoas abscess (+) | Salmonella choleraesuis | A + A′ + A″ + P | Survived, ambulation without aid |
| 2 | 50/M | Diabetic mellitus | Back pain with fever | 2 weeks | 12,800 | L3–L4 | Endplate destruction (−) Vertebral body collapse (−) |
Bilateral psoas abscess (+) | Salmonella choleraesuis | A + A′ | Survived, ambulation without aid |
| 3a | 79/M | CHF, Hypertension Adrenal insufficiency |
Back pain, abdominal pulsating mass, lower limb weakness (grade 3 of 5 motor strength) | 1 week | 12,600 | L3–L4 | Endplate destruction (−) Vertebral body collapse (−) |
Bilateral psoas abscess (+) |
Salmonella enteriditis Mycobacterium tuberculosis |
A + A′ + A″ + P | Survived, ambulation with wheelchair |
| 4 | 72/M | CHF, COPD | Back pain, fever, abdominal pulsating mass, lower limb weakness (grade 4 of 5 motor strength) | 3 weeks | 15,600 | L3–L4 | Endplate destruction (−) Vertebral body collapse (−) |
Bilateral psoas abscess (+) | Salmonella choleraesuis | A + A′ | Survived, ambulation with crutches |
| 5 | 81/M | Old stroke, COPD | Back pain, abdominal pain and fever | 4 weeks | 13,800 | L5 | Endplate destruction (+) Vertebral body collapse (+) |
Bilateral psoas abscess (+) | Streptococcus pyogenes | None | Died (rupture of aneurysm) |
| 6 | 59/F | ESRD, HCVD | Back pain, paraplegia and fever | 1 week | 12,500 | T7 | Endplate destruction (+) Vertebral body collapse (−) |
Paravertebral mass (+) | Staphylococcus aureus | None | Died (septic shock) |
Abbreviations: CHF congestive heart failure, COPD chronic obstructive pulmonary disease, CT computed tomography, ESRD end-stage renal disease, HCVD hypertensive cardiovascular disease, MRI magnetic resonance imaging, WBC white blood cell
aSalmonella enteriditis mycotic aneurysm and mycobacterium tuberculosis spondylitis
bSurgical methods: A: anterior approach for aneurysm resection, A′: A with psoas abscess debridement and sequestrectomy, A″: A′ + interbody fusion, P: posterior approach with internal instrumentation