PMC6698504_01
Coronal view (a) and axial view at L5/S (b) of contrast-enhanced computed tomography (CT) showing abscesses in the retroperitoneal space, epidural space, and paravertebral muscles (arrows), with an osseous lesion at the left L5/S facet joint. Axial view at L5/S (c) on CT showing facet joint destruction, indicating that the facet joint was the focus of the infection.
2432-261X-2-0159-g001.jpg
PMC6698504_01_2432-261X-2-0159-g001.jpg
g001
C-reactive protein concentration was elevated to 22.2 mg/L. Contrast-enhanced computed tomography (CT) showed a huge retroperitoneal abscess that compressed the psoas muscle and abdominal organs (Fig. 1). We found a lytic change in the left L5/S facet joint (Fig. 1b, 1c).
Sagittal view (left) and axial view at L5/S of T2-weighted magnetic resonance imaging (MRI) showing that the focus was at the left L5/S facet joint and that the spinal canal was occupied by the abscess (arrows).
2432-261X-2-0159-g002.jpg
PMC6698504_01_2432-261X-2-0159-g002.jpg
g002
MRI of the lumbosacral spine showed an abscess at the left L5/S facet joint, that had invaded into the paraspinal muscles, epidural space, and retroperitoneal space (Fig. 2).
Sagittal view (a) and axial view at L5/S (b) of T2-weighed MRI and axial view at L5/S of CT (c) 3 months after the start of treatment. The abscesses in the epidural space and retroperitoneal space had nearly disappeared.
2432-261X-2-0159-g003.jpg
PMC6698504_01_2432-261X-2-0159-g003.jpg
g003
The abscesses in the epidural space, retroperitoneal space, and paravertebral muscles had nearly disappeared at 3 months after treatment (Fig. 3).