Abstract | STUDY DESIGN: A case report. OBJECTIVE: SUMMARY OF BACKGROUND DATA:
Spondylodiscitis, an infection of the intervertebral disc space, vertebral bodies, or the paraspinal epidural space can be a serious disease because of diagnostic delay and inadequate treatment. METHODS: A previously healthy, 52-year-old man was presented to our outpatient clinic with a complaint of acute, atraumatic onset of severe back pain for more than 1 month. Initially, he was misdiagnosed at another clinic as myofascial pain and treated with nonsteroidal anti-inflammatories and physical therapy, which he did not benefit from. He never complained of fever; however, laboratory tests revealed raised erythrocyte sedimentation values, increased C-reactive protein values but normal leukocyte count. Thoracal and lumbal plain radiographs were nonspecific. Magnetic resonance imaging demonstrated increased signal intensity in vertebral bodies and intervertebral disc space through T12-L4 and in the paravertebral musculature at L2-L3 with contrast enhancement. Blood cultures and computed tomography-guided needle biopsy and cultures were negative. RESULTS: The patient was treated with oral amoxicillin and clavulanate and responded very well clinically; however, imaging examinations were repeated up to 6 months because of multilevel involvement. Follow-up magnetic resonance imaging findings at 3 months and 6 months showed decreased signal intensity, and luckily, there was no evidence of vertebral destruction. CONCLUSION: Diagnosis of spondylodiscitis could be challenging and commonly missed; however, it should always be included in the differential diagnoses of back pain in the middle aged and healthy population.
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Authors | Oya Umit Yemisci, Sacide Nur Saracgil Cosar, Pnar Oztop, Metin Karatas |
Journal | Spine
(Spine (Phila Pa 1976))
Vol. 35
Issue 19
Pg. E1006-9
(Sep 01 2010)
ISSN: 1528-1159 [Electronic] United States |
PMID | 20395882
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Biomarkers
- Amoxicillin-Potassium Clavulanate Combination
- C-Reactive Protein
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Topics |
- Administration, Oral
- Amoxicillin-Potassium Clavulanate Combination
(administration & dosage)
- Back Pain
(microbiology)
- Biomarkers
(blood)
- Biopsy
- Blood Sedimentation
- C-Reactive Protein
(analysis)
- Discitis
(blood, diagnosis, microbiology, pathology)
- Humans
- Leukocyte Count
- Lumbar Vertebrae
(pathology)
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Severity of Illness Index
- Thoracic Vertebrae
(pathology)
- Tomography, X-Ray Computed
- Treatment Outcome
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