A big challenge in the diagnosis of spondylodiscitis with multiple risk factors: a case report

Spondylodiscitis is a combination of discitis (inflammation of one or more intervertebral disc spaces) and spondylitis (inflammation of one or more vertebrae), the latter generally involving the areas adjacent to the intervertebral disc space. Spondylodiscitis is the most common spinal infection and the most common complication of sepsis or local infection, usually in the form of an abscess and is characterized by an increasing incidence. The main causative organisms are staphylococci, but potential organisms include a large number of bacteria, fungi, zoonoses. Spondylodiscitis frequently develop in immunocompromised individuals, such as by a cancer, infection, or by immunosuppressive drugs used for organ transplantations. Chronic back pain is the most common nonspecific presentation and diagnosis is often delayed. We present the case of a patient admitted for pain in the lumbar spine of increased intensity, initially without imaging signs of spondylodiscitis, but with the subsequent development of changes compatible with this diagnosis. The patient was treated with appropriate antibiotic therapy, with an undulating evolution determined by multiple complications that evolve to the present comorbidities.