Anaesthetic challenges in a case of psoas abscess with discovertebral destruction at lumbar vertebral level with severe mitral regurgitation, severe aortic regurgitation and extrapulmonary tuberculosis

It is recommended to take a cautious approach when vertebral lesions are discovered in one or two vertebrae but there is no significant disruption in the vertebral stability.We describe a 38-year-old male with Pott's disease of the lumbar spine with extensive psoas abscesses.The patient also had multiple ground glass opacities in right lungs, along with severe aortic regurgitation and mitral regurgitation.The patient was started on anti-tubercular therapy.On the day of surgery, he was induced under general anaesthesia with central venous catheterization and arterial canulation for better haemodynamic management.The abscess was drained in a prone position followed by fixation of the spine.The anaesthetic management was a challenge because of multiple issues the patient had, be it the psoas abscess, extrapulmonary tuberculosis, bad lung mechanics and cardiac changes.An appropriate preoperative assessment and judicious intraoperative planning and management could help us handle the case smoothly.Postoperatively the patient was extubated on the table and shifted to intensive care for observation and further management.