Multi-Stage Pyocyanic Spondylodiscitis: A Case Report

Author(s): Ilyas El Kassimi, Adil Rkiouak, Salah-Eddine Hammi, Nawal Sahel, Oumama Jamal, Youssef Sekkach

Spondylodiscitis is an intraspinal infection that affects the intervertebral disk and adjacent vertebral bodies. Neurological signs represent urgency and a criterion of gravity. Magnetic resonance imaging (MRI) is the baseline assessment to make the diagnosis. Pyocyanic bacillus represents less than 5% of bacterial causes. We report the case of a 79-year-old woman who progressively presented paresthesia of the four limbs with flaccid tetraparesis. MRI showed multi-stage cervico-dorsal involvement. Based on that, computed tomography-guided disco vertebral biopsy was performed and permitted to isolate a pyocyanic agent. The treatment consisted of a double antibiotherapy with resuscitation measures. The evolution was favorable, and the entry gate remained mysterious.