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Abstract

A 25-year-old man, with a history of Crohn's disease undergoing biological treatment, seeks Open Consultation for low back pain and a fever spike. Due to low back pain associated with alarming signs, he is referred to the Emergency Department, where he undergoes imaging and analytical studies, showing slight leukocytosis. Discharged with a presumed diagnosis of nonspecific low back pain. The clinical condition progressively worsens.Upon reassessment, he exhibits a positive Patrick's test. Another imaging study is requested, showing no abnormalities. Magnetic resonance imaging is performed, diagnosing infectious sacroiliitis with extensive abscesses.
During hospitalization, multiple cycles of antibiotic therapy are administered and several attempts to drain the collections are unsuccessful. Discharged after 54 days with progressive functional recovery. This case aims to alert to the increased susceptibility to infections associated with the use of biological agents and the added complexity in managing patients with inflammatory bowel disease.