PMC5623770_01
Lumbar spine MRI from July 6; arrow designates 12 x 3 x 3 cm abscess posteriorly with severe cord compression of the thecal sac, most prominent at the L4-L5 level (T2-weighted image provided by Craig Sherman).
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IV was administered by extended infusion over 4 hours TID as empiric coverage. Images (Figure 1) revealed posterior spinal fusion with rods and screws L2-S1, along with a 12 x 3 x 3 cm fluid collection posteriorly with severe cord compression of the thecal sac, most prominent at the L4-L5 level.
MRI from October 9; arrow designates a 3.5 cm fluid collection posterior to the thecal sac at the L5 level; aspiration proved sterile (T2-weighted image provided by Craig Sherman).
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On October 9, images revealed no evidence of discitis or osteomyelitis; however, posterior to the thecal sac at the L5 level, there was a 3.5 cm fluid collection (Figure 2).
Culture results, procedures, and timing of antibiotic administration.
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This specimen proved to be sterile, with no growth after 5 days of incubation.  Figure 3 summarizes the patient's hospital course with timing of antibiotic, procedure, and culture results at our institution.