Vertebral osteomyelitis with posterior mediastinal abscess caused by Staphylococcus aureus: A case report

A preterm infant presented with intermittent fever, tachypnea, and exertional cyanosis at the age of 1 month was referred to our hospital because the echocardiograph showed a posterior mediastinal mass. Physical examination revealed thoracic kyphosis and a paravertebral bulging mass. The chest roentgenograph showed a pneumonia-like patch and destruction of T6-T8 vertebrae. Magnetic resonance imaging demonstrated an abscess in the posterior mediastinum with destruction of the 7th thoracic vertebra and epidural extension. Thoracotomy and pus drainage were performed immediately. Both the blood and pus cultures grew methicillin-resistant Staphylococcus aureus (MRSA). Parenteral vancomycin was given for six weeks. No neurological sequelae nor recurrence of infection were noted after 3 years of follow up. progressive thoracic kyphosis developed at 3 years of age and he received a posterior lateral fusion operation which successfully stopped the progress of kyphosis.