Thoracic empyema and vertebral osteomyelitis is a rare combination, We
report a case of vertebral osteomyelitis possibly caused by a progres
sive thoracic empyema. The causative pathogen was Escherichia coli, Co
mputed tomographic (CT) scan and magnetic resonance imaging (MRI) sugg
ested the diagnosis of vertebral osteomyelitis, confirmed by transthor
acic needle aspiration and operative findings. Aetiology and treatment
are discussed.