Gas Forming Infection of the Spine: a Case Report

Abstract

Gas-forming infection is a rapidly progressive and life-threatening soft tissue infection. Gas-forming infection with spine manifestations is extremely rare and can be a result of several entities including necrotizing fasciitis (NF) and emphysematous osteomyelitis. We present a case of a 68-year-old man who presented with a 1 week back pain and fever. His lab results supported a high-intensity inflammation process. Due to a positive urinalysis, he was treated for a urinary tract infection as the suspected origin to his symptoms. Shortly following admission, the patient’s condition declined. Following an orthopedic surgeon consultation, a CT scan of the lumbar spine was obtained and demonstrated gas-forming infection process that involved the spine, epidural space, and surrounding muscles. The patient underwent several surgical procedures in attempt to reduce the infected tissues and the local pressure. Despite aggressive debridement of the spine and maximal medical therapy, the patient passed away due to multisystem organ failure. Spine involvement in gas-forming infection is a rare entity with very poor prognosis, requiring early and aggressive surgical treatment. A multidisciplinary approach is necessary for management. Nevertheless, even with proper and optimal management, multisystem failure and mortality still may occur.