Case reports: spondylodiscitis and epiduritis after suffering COVID-19

Abstract

Background: The study analyzes a possible rare complication of COVID-19 in the form of spondylodiscitis, including that followed by epiduritis, in patients who survived COVID-19 characterized by severe pneumonia, respiratory failure and systemic inflammatory response syndrome (SIRS).

Clinical case description: Three clinical cases of patients are presented, each of whom had high fever, SIRS with a significant increase in the laboratory markers of inflammation (C-reactive protein (CRP), leukocytosis, erythrocyte sedimentation rate (ESR), fibrinogen, procalcitonin, ferritin), bacterial pneumonia, and severe hemostasis disorders. Despite an antibiotic therapy with broad-spectrum drugs, the development of spondylodiscitis was observed, manifested as acute pain syndrome in the lumbar spine. In the first patient, against the background of a massive antibacterial therapy, revisions of purulent foci, therapy with glucocorticosteroids (GCS), and a surgical treatment, there was significant positive dynamics in the form of the pain syndrome relief. The second patient showed positive dynamics against the background of a conservative antibacterial therapy. The third patient, with a paravertebral abscess at the level of developed spondylodiscitis, received a massive antibiotic therapy combined with GCS, and was operated for the spinal cord decompression.

Conclusion: Spondylodiscitis and epiduritis may be possible complications of COVID-19, including those resulting from the immunosuppressive therapy, which is actively used to stop the cytokine storm.

Keywords

COVID-19 / neurologic diseases / nervous system / spondylodiscite / epidural abscess / low back pain / red flags / case report

RIGHTS & PERMISSIONS

Ustenko I.I., Kushnir Y.B., Amelin A.V., Gotovchikov A.А., Goranchuk D.V., Kulikov A.N.