To clinically examine and review patients with perivertebral infection diagnosed during treatment for urinary tract infection.

The subjects were 3 patients in whom a diagnosis of perivertebral infection was made during hospital treatment for urinary tract infection between January and December 2023.

Case 1. A 74-year-old female. A chief complaint was consciousness disorder. She had received diabetes treatment. She had fallen in her garden, and was taken to a hospital by ambulance. Detailed examination led to a diagnosis of emphysematous pyelonephritis. Low back pain exacerbated 54 days after admission, and magnetic resonance imaging (MRI) was performed. A diagnosis of L3/4 discitis was made. Orthopedic treatment was continued for 3 months. Case 2. An 87-year-old male. He complained of high fever and low back pain. He consulted a hospital with fever (≥38C) and low back pain. Under a diagnosis of pyelonephritis, he was admitted. Subsequent detailed examination led to a diagnosis of calculous pyelonephritis and bacteremia. Ureteral stenting was performed, and treatment with an antimicrobial drug was continued. MRI was performed due to severe low back pain, leading to a diagnosis of iliopsoas abscess. Orthopedic treatment was continued for 2.5 months. He had been admitted to a previous hospital under a diagnosis of pyelonephritis one month earlier. Case 3. An 84-year-old female. She complained of high fever and abdominal/low back pain. Due to left ureteral cancer, she had hydronephrosis. Detailed examination led to a diagnosis of pyelonephritis and bacteremia. Ureteral stenting was performed, and antimicrobial drug administration was started. She complained of femoral pain 15 days after admission, and computed tomography (CT) was performed. A diagnosis of pyogenic spondylitis was made. Treatment for ≥2 months was required. She had undergone hospital treatment under a diagnosis of pyelonephritis one month earlier.

It is necessary to perform detailed examination of continuous low back pain during treatment for urinary tract infection using procedures, such as MRI, in cooperation with orthopedic surgeons.