Spondylodiscitis developing in a young man - diagnostic and therapeutic difficulties

Abstract

Infectious spondylodiscitis is characterized by vertebral osteomyelitis, spondylitis, and discitis. Patients present with persistent low back pain, fever, or neurological findings. Diagnosis is made with a combination of clinical, radiological, and laboratory findings. Magnetic resonance tomography (MRI) has high sensitivity and specificity in diagnosis and differentiation of the type of spondylodiscitis and may reveal signs of spondylodiscitis even in very early stages. Infectious spondylodiscitis responds to antimicrobial therapy well if diagnosed early before development of neurological deficit and requirement of surgical intervention. We present a clinical case of spondylodiscitis developing in a young immunocompetent man without any predisposing factors.

Keywords: Staphylococcus aureus; infectious spondylodiscitis; magnetic resonance tomography.

Fig. 1

X-ray of sacroiliac joints manifested rough right sacroiliac joint.

Fig. 2

Computed tomography of the spine demonstrated destruction of the L1–L2 disk space with the adjacent L1 and L2 vertebral bodies, as the contiguous m. iliopsoas was affected.

Fig. 3

MRI of the spine (May 2017) showed destruction of the L1–L2 and L3–L4 disk spaces with the adjacent vertebral bodies, as an abscess in the structure of the right m. iliopsoas.