A Highly Rare Cause of Lumbar Spondylodiscitis with Epidural Abscess: Actinomyces israelii
Figure 1
(a) PET-CT image of the patient showing pulmonary and lumbar vertebral involvement (arrows). (b) Poor orodental hygiene of the patient of heavy smoking hand-rolled tobacco. (c) T1 weighed sagittal MRI of the spine showing edema and postcontrast involvement in L4-5 vertebral bodies and postcontrast uptake L4-5 intervertebral disc (arrow) and adjacent iliopsoas muscle (not shown in this image). (d) T2 weighed sagittal MRI reveals epidural fluid with an 8 mm width at most between T12 and S1 vertebrae, in an unconnected extension with peripheral contrast involvement. There are a marked spinal cord and neural foraminal compression (arrows). Actinomyces israelii was isolated from the culture of the abscess and disc material.
