Article Text

Download PDFPDF
Back Pain in a Bangladeshi Worker in Iraq
  1. SH White1,
  2. S Dickson1,
  3. T Colman1,
  4. F Hoque2 and
  5. Christopher Boos3
  1. 1Royal Centre for Defence Medicine, Birmingham, and Hospital Squadron, UK Medical Group, Op Telic, BFPO 641
  2. 2Department of Orthopaedics and Spinal Surgery, Square Hospital, 18/F West Panthapath, Dhaka - 1205, Bangladesh
  3. 3Department of Cardiology, Poole Hospital, Longfleet Rd, Poole, Dorset
  1. 22 Barber’s Wharf, Poole Quay, Poole, Dorset, BH15 1ZB Christopherboos{at}


Pyogenic Spinal Infection (PSI) is an uncommon disorder encompassing a broad spectrum of diseases including septic spondylodiscitis, osteomyelitis, epidural and paravertebral abscess formation. Presentation can be vague and highly variable but usually includes back pain and fever. Whilst predisposing factors, such as trauma and diabetes can often be identified a pathogenic organism may not be identified in up to a half of all cases leading to significant delay in both accurate diagnosis and effective treatment. Precise spinal imaging is essential and includes plain X-ray, CT and preferably MRI. The treatment of PSI can be conservative (including antibiotics); however, spinal surgery may be required for the complications in up to 50% of cases, with varying degrees of success. We present a challenging case of PSI encountered in a locally-employed 42 year-old Bangladeshi civilian working in Iraq. Despite obvious resource limitations available within a Role 2 Field Hospital, clinical suspicion coupled with repeat spinal CT was pivotal in obtaining the diagnosis. The patient was repatriated to Bangladesh for MRI and definitive surgical treatment.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.