CTICasesSeptal emboli and spinal discitis/osteomyelitis with paravertebral abscess
Imaging findings
CT scan of an intravenous drug user with methicillin-sensitive Staphylococcus aureus (MSSA) endocarditis shows multiple peripheral, non-cavitating septic emboli. Sagittal CT of the lower thoracic spine demonstrates severe endplate destruction of two adjacent vertebral bodies, narrowing of the disc space, and a large paravertebral abscess.
Key takeaways
Intravenous drug abuse-related endocarditis frequently causes septic emboli and can seed the axial skeleton, leading to discitis, osteomyelitis, and paravertebral or epidural abscesses. Spinal symptoms in these patients require prompt imaging.
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