This is a 42-years old woman who had a CT myelogram done for CSF leak. The leak was found and repaired.
Three months later she had gradually progressive back pain at the site of the lumbar puncture. MRI revealed an infectious discitis at this level. The CT done at the time of the biopsy also shows typical findings.
While tuberculosis was always on the top of the list of differential diagnosis, the chance of this being non-tuberculous was much higher.
A CT guided biopsy was done from the end-plates, disc and the adjacent soft tissue. It grew Pseudomonas aeruginosa. #CTbiopsy #spine #infection #discitis #pseudomonas