Vascular infection and vertebral destruction in a patient with Q fever

A 66-year-old man presented with lumbar pain and low-grade fever that had persisted for 2 months. 5 years before this admission, he had been treated for an abdominal aortic aneurysm with an aortic stent graft. A CT scan revealed bilateral paravertebral and psoas muscle abscesses (figure), spondylitis with destruction of the second and third lumbar vertebral bodies (figure), and a distal migration of the stent, which was embedded in the third lumbar vertebral body (appendix).