A Case Series of Spinal Infections Following COVID-19: A Delayed Complication.

Spinal infection in the form of tuberculous vertebral osteomyelitis or pyogenic spondylodiscitis is a commonly associated state of an immunodeficient host from various pathologies. For example, secondary infections can be seen following coronavirus disease 2019 (COVID-19). We report three cases of different forms of spinal infections that occurred as delayed complications to recent COVID-19 infection. The first case is a 60-year-old female who was diagnosed with an epidural abscess presenting with severe back pain and bilateral lower limb weakness. The second case is an elderly male who was diagnosed with L3/L4 spondylodiscitis and presented with predominantly back pain and minimal leg symptom. The final case is a young female who was diagnosed with severe T5 tuberculous spondylitis and presented with a complete sensory and motor deficit from T5 below. All patients showed good improvement after surgery and antibiotic therapy. Patients treated for COVID-19 are at risk of spinal infection development due to multiple pathophysiologies. Treatment of these various forms of spinal infection remains difficult, and we encourage physicians to be vigilant for the development of these complications post COVID-19 infection.

Literature review and case report of bilateral extensive psoas abscess: A rare case of spondylomyelitis with infection spread to Hunter's canal with a rare causative microorganism.

A 43-year-old male patient with underlying diabetes mellitus presented with lower abdominal pain radiating to left thigh. He was hemodynamically stable, but appeared lethargic. Both iliac fossae were tender, and crepitus appreciated along the anteromedial aspect of the left thigh. The patient initially responded well to treatment and was discharged; however, he was re-admitted several months later due to recurrent collection showing the growth of Klebsiella pneumoniae in the culture and succumbed to sepsis due to deep-seated intramuscular abscess and lung empyema. In conclusion, psoas abscess is a condition that can mimic various pathologies related to the lower abdomen and, therefore, clinicians should always have a high index of suspicion to prevent a missed diagnosis. Early detection may yield good outcomes, if managed with adequate surgical drainage and appropriate antibiotics.