A Rare Case of Vertebral Osteomyelitis and Bilateral Psoas Abscess From an Unknown Source

We present a case of a 31-year-old Filipino man with vertebral osteomyelitis and bilateral psoas abscesses. Vertebral osteomyelitis is a rare infection of the bone and bone marrow that affects the vertebral column. The patient’s initial presentation included a 1-week history of cough, fatigue, diarrhea, fevers, and a 40-pound weight loss. An extensive workup including a computed tomography (CT) scan of the abdomen and pelvis demonstrated bilateral psoas abscesses with subcutaneous air tracking into the right flank. Blood cultures revealed Escherichia coli , Streptococcus anginosus , and Bacteroides . However, with an unclear primary source of infection, the most likely causative factor we believed to be due to immobility.