PMC9353035_01
Clinical data. (A) The hospitalization course, with the timeline of antibiotic treatment and the changes in body temperature and inflammatory markers. (B1, B2) The first MRI scan of the patient showed a lesion on the lower 1/2 part of the fourth lumbar vertebra (white arrow), with low intensity on T1WI and high intensity on T2WI. (C1, C2) The second MRI scan, which occurred on follow-up day 27, showed that the lesion had expanded (white arrow), involving the posterior lower part of the fourth lumbar vertebra and with fusiform abscess formation behind the fourth vertebral body and lumbosacral soft tissue edema. (D1, D2) The last MRI scan (white arrow) after 3 months showed that the lower edge endplate of the fourth lumbar vertebra was damaged, the L4/L5 intervertebral disc was turbid, the retrovertebral abscess had disappeared, and the lumbosacral soft tissue edema was significantly improved. ESR, erythrocyte sedimentation rate; CRP, C-reactive protein.
fimmu-13-923341-g001.jpg
PMC9353035_01_fimmu-13-923341-g001.jpg
f1
The levels of C-reactive protein (CRP) and interleukin-6 (IL-6) were slightly elevated to 28.93 mg/L and 10.88 pg/ml, respectively ( Figure 1A ). Magnetic resonance imaging (MRI) showed abnormalities suggesting inflammation in the L4 region ( Figure 1B ). The second MRI ( Figure 1C ) scan of the spinal cord showed lesion expansion involving the lower posterior part of L4 and focal abscess formation. After the overall 14-week treatment course, the third MRI scan ( Figure 1D ) showed that the lower edge endplate of L4 had been damaged, the paravertebral abscess had disappeared, and the lumbosacral soft tissue edema had significantly improved.