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His admission was complicated by a number of issues, including the development of osteomyelitis with vertebral body destruction at multiple sites, epidural abscess formation and deep vein thrombosis. Additionally, the patient developed severe sepsis which necessitated admission to the intensive care unit. The patient\u2019s clinical condition improved gradually with intravenous antibiotics until he was well enough for transfer to a rehabilitation centre, where he underwent regular occupational and physical therapy. Repeat imaging showed overall resolution of the aforementioned pathologies and is currently being followed up by the spinal surgeons on an outpatient basis.<\/jats:p>","DOI":"10.1136\/bcr-2020-238522","type":"journal-article","created":{"date-parts":[[2020,12,28]],"date-time":"2020-12-28T12:20:29Z","timestamp":1609158029000},"page":"e238522","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Lumbosacral spondylodiscitis complicated by sepsis, osteomyelitis, epidural abscess formation and deep vein thrombosis"],"prefix":"10.1136","volume":"13","author":[{"given":"Etienne","family":"Ceci Bonello","sequence":"first","affiliation":[{"name":"Rheumatology, Mater Dei Hospital, L-Imsida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Vassallo","sequence":"additional","affiliation":[{"name":"Rheumatology, Mater Dei Hospital, L-Imsida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul John","family":"Cassar","sequence":"additional","affiliation":[{"name":"Rheumatology, Mater Dei Hospital, L-Imsida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,12,28]]},"reference":[{"key":"2025082707172660000_13.12.e238522.1","doi-asserted-by":"crossref","first-page":"173","DOI":"10.5935\/1806-0013.20170034","article-title":"Low back pain \u2013 a diagnostic approach","volume":"18","author":"Almeida","year":"2017","journal-title":"Revista Dor"},{"key":"2025082707172660000_13.12.e238522.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f7095"},{"key":"2025082707172660000_13.12.e238522.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.07.035"},{"key":"2025082707172660000_13.12.e238522.4","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jtcvs.2018.08.079","article-title":"Induction of human aortic myofibroblast-mediated extracellular matrix dysregulation: a potential mechanism of fluoroquinolone-associated aortopathy","volume":"157","author":"Guzzardi","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025082707172660000_13.12.e238522.5","first-page":"223","article-title":"Acute lumbar back pain","volume":"113","author":"Casser","year":"2016","journal-title":"Dtsch Arztebl Int"},{"key":"2025082707172660000_13.12.e238522.6","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/s00701-018-3467-2","article-title":"Management of spinal infection: a review of the literature","volume":"160","author":"Lener","year":"2018","journal-title":"Acta Neurochir"},{"key":"2025082707172660000_13.12.e238522.7","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-008-1051-5"},{"key":"2025082707172660000_13.12.e238522.8","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1016\/j.spinee.2013.09.027","article-title":"Spinal brucellosis in South of Tunisia: review of 32 cases","volume":"14","author":"Koubaa","year":"2014","journal-title":"Spine J"},{"key":"2025082707172660000_13.12.e238522.9","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/01.blo.0000203452.36522.97","article-title":"Spinal infections: diagnostic tests and imaging studies","volume":"444","author":"An","year":"2006","journal-title":"Clin Orthop Relat Res"},{"key":"2025082707172660000_13.12.e238522.10","doi-asserted-by":"crossref","first-page":"476","DOI":"10.3390\/microorganisms8040476","article-title":"Spinal infections: an update","volume":"8","author":"Tsantes","year":"2020","journal-title":"Microorganisms"},{"key":"2025082707172660000_13.12.e238522.11","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e31819d2748"},{"key":"2025082707172660000_13.12.e238522.12","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-011-1384-6"},{"key":"2025082707172660000_13.12.e238522.13","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ482"},{"key":"2025082707172660000_13.12.e238522.14","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00134-14"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-238522","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:17:36Z","timestamp":1756304256000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-238522"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":14,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12,28]]},"published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1136\/bcr-2020-238522"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-238522","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12]]}}}