Discitis

Cathy is a 35 year old woman with a history of IV drug use who presented initially with fevers and low back pain. Her MRI showed an abnormality in the disc at L3-4. A sample of the disc was obtained through a needle that grew bacteria. Cathy was diagnosed with discitis.

Initially, therapy was with IV antibiotics. Subsequent MRI scans showed progression of the infection. She had a surgery to relief pressure on the nerves in her back and to clean out some of the infection.

Despite surgery and antibiotic therapy, Cathy’s lumbar spine at L3 and L4 started to fall forward, leaving her unable to walk or even straighten her back. Cathy underwent surgery to correct the spinal deformity.

Cathy’s story helps us understand a few important things about discitis and osteomyelitis.

1. There isn’t a blood supply to the discs in the spine. If bacteria can make it into the disc, they can grow without much suppression from the immune system and spread from there.

2. Discitis should be treated aggressively with antibiotics.

3. To prevent deformity of the spine, spinal bracing and even sometimes spinal fusion is required.

Disclaimer: Although this is a real patient, I have used a different name for privacy protection and added a few details for educational purposes. This patient gave consent to have his case shared.

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