What caused this abscess?

Question
What do you know about a paravertebral abscess?

How is it caused?

Answer
This is quite a difficult question because paravertebral abscesses are pretty rare.

Most doctors won't have come across one, and references on the subject are not easy to
find.

Abscesses themselves are relatively common in the form of boils in or under the skin
(furuncles or carbuncles).

They occur when a focus of bacterial infection becomes isolated within a collection of
pus by the body's immune defence system. Most folk get at least one at some point in
their lives.

An abscess makes you feel unwell with fever and a painful, tender swelling at the site of
infection. It usually only settles properly once the collection of pus has discharged
spontaneously or been drained surgically.

It's the word 'paravertebral' that is difficult. It suggests an abscess occurring close to,
often involving, the bones of the spinal column (the vertebrae).

This is an unusual location that presents additional risks associated with infection in the
spine itself (vertebral osteomyelitis and discitis)

Apart from the back pain, fever and malaise that goes with any such infection, there is the
problem of the abscess swelling in such a way as to cause pressure on nearby structures,
including nerves.

A paravertebral abscess is usually caused by bacteria (including tuberculosis), but more

rarely fungi.

Such bugs probably arrive from another site of infection via the bloodstream. Infection
can also occur as a complication of injury, surgery or other invasive procedures.

In general, it's more likely to happen to someone who is already ill and has an over-
stretched or compromised immune system.
The diagnosis can be confirmed without difficulty on modern scans.

Treatment not only involves antibiotics selected to target the bugs responsible, but also
surgery to drain the abscess and remove any tissue that might harbour infection.

This means general anaesthetics, time in hospital, and antibiotic medication for some
weeks after the diagnosis. It's a major problem, but one that can be cured effectively.

Yours sincerely

The NetDoctor Medical Team

Last updated 01.04.2007