MRI demonstration of cervical spondylodiscitis and distal full-length bilateral paraspinal cold abscesses successfully treated by drug regimen only.
OBJECTIVE
Cold abscesses, although common in spinal tuberculosis, are usually localized to the level of infection, follow tissue planes, and may extend into the spinal canal at any level. They may cause symptoms resulting from neurovascular compression, hemorrhage, and direct mass effect.


METHODS
We present an unusual case of cervical tuberculous spondylodiscitis in a 25-year old man with a cold abscesses involving the retropharyngeal, mediastinal, and retroperitoneal areas bilaterally. The abscess tracked from the neck to the psoas muscles bilaterally. Following the diagnosis the patient received 9 months of antituberculous therapy.


RESULTS
MRI showed resolution on medical treatment alone.


CONCLUSIONS
Even in the presence of massive paravertebral cold abscesses medical treatment alone may well suffice for this common worldwide disorder. MRI is ideal for monitoring regression of massive abscesses in deep anatomical locations.
Unal
Ozkan
O
Department of Radiology, Medical Faculty, Yüzüncü Yil University, Maraş, 65200 Cad Van, Turkey. ozkan_unal@hotmail.com
Kayan
Mustafa
M
Akpinar
Fuat
F
Cankaya
Hakan
H
Akdeniz
Necmettin
N
D000038:Abscess / Q000175:diagnosis* / Q000188:drug therapy; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D002574:Cervical Vertebrae; D015299:Discitis / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013122:Spinal Diseases / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000175:diagnosis* / Q000188:drug therapy
D000995:Antitubercular Agents