A surgical case of bilateral acute empyema due to pyogenic vertebral osteomyelitis

The patient was a 43-year-old male long-distance truck driver. Two days before admission to our hospital, he visited a local doctor complaining of fever and back pain and was admitted to the hospital with a diagnosis of right acute empyema. Right chest tube drainage was performed. On the day after admission, he developed rapidly progressive bilateral lower limb paralysis. Re-reading of an earlier image obtained by computed tomography (CT) revealed suspected pyogenic vertebral osteomyelitis, and so he was transferred to our hospital. Decompression was considered urgent and a laminectomy was performed. Despite drainage, the permeability of the right lung field gradually decreased, and the permeability of the left lung field also decreased. Considering pyogenic vertebral osteomyelitis, early effective drainage was necessary. On the 5th day after posterior decompression, we successfully performed video-assisted thoracoscopic surgery. The postoperative course was good, and thoracic drainage was removed bilaterally 13 days after the operation. On the 27th postoperative day, he had recovered and was able to walk with a cane and was transferred to a rehabilita-tion facility. We reported a surgical case of bilateral acute empyema due to pyogenic vertebral osteomyelitis.