Pyogenic Spondylitis Following Crohn's Disease - A Case Report

A 48-year-old male was admitted to our hospital for high fever, abdominal pain and back pain. He had Crohn's disease and resulting stenosis of the ileum. He had been treated with IFX nine times. A bacterial culture test showed Klebsiella pneumonia and we diagnosed sepsis from the stenotic lesion of the ileum. Antibiotic therapy was not effective, so we operated on his stenotic ileum. After the operation, chest CT examination showed an extradural compression and we diagnosed pyogenic spondylitis. Rest and antibiotic therapy continued for about one month and his pyogenic spondylitis was healed. IFX treatment of the stenotic lesion of Crohn's disease predisposes the patient to sepsis and pyogenic spondylitis. Therefore, we may consider operating on the stenotic lesion first, and then using IFX.