Kunj Patel1, Lauren Hutts2, Stephen Porter1, Zachary Fausel1, Dale Strasser1. 1. 1Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, USA. 2. 2Department of Physical Medicine and Rehabilitation, University of Alabama-Birmingham School of Medicine, Birmingham, USA.
Abstract
INTRODUCTION: Discitis is an infection of the intervertebral disc space that can lead to paralysis, sepsis, epidural abscess, or other life-threatening complications if left untreated and may sometimes present with limited laboratory abnormalities to clue a diagnosis. CASE PRESENTATION: We present a case of a 67-year-old female in an acute rehabilitation setting who had presenting symptoms of sudden unexplained back pain refractory to pain control. She had a previous history of discitis and multiple failed knee replacement surgeries secondary to MSSA infections. Although vitals and basic labs were within normal limits, we recognized the clinical presentation as an indicator to order inflammatory markers (CPR and ESR), which were elevated compared to levels on admission, and subsequently ordered imaging and blood cultures to detect a case of recurrent worsening discitis. DISCUSSION: We highlight the presentation of recurrent discitis and necessary low threshold needed to detect such recurrence in patients with a previous history of discitis that have sudden unexplained back pain with no other usual physical or laboratory indicators of infection.
INTRODUCTION: Discitis is an infection of the intervertebral disc space that can lead to paralysis, sepsis, epidural abscess, or other life-threatening complications if left untreated and may sometimes present with limited laboratory abnormalities to clue a diagnosis. CASE PRESENTATION: We present a case of a 67-year-old female in an acute rehabilitation setting who had presenting symptoms of sudden unexplained back pain refractory to pain control. She had a previous history of discitis and multiple failed knee replacement surgeries secondary to MSSA infections. Although vitals and basic labs were within normal limits, we recognized the clinical presentation as an indicator to order inflammatory markers (CPR and ESR), which were elevated compared to levels on admission, and subsequently ordered imaging and blood cultures to detect a case of recurrent worsening discitis. DISCUSSION: We highlight the presentation of recurrent discitis and necessary low threshold needed to detect such recurrence in patients with a previous history of discitis that have sudden unexplained back pain with no other usual physical or laboratory indicators of infection.
Authors: John L Go; Stephen Rothman; Ashley Prosper; Richard Silbergleit; Alexander Lerner Journal: Neuroimaging Clin N Am Date: 2012-10-02 Impact factor: 2.264
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