[Spondylodiscitis as cause of unexplained fever]

Area of Science:

• Infectious Diseases
• Radiology
• Orthopedic Surgery

Background:

• Sepsis can present with diverse symptoms, sometimes masking underlying spinal infections.
• Delayed diagnosis of spondylodiscitis is common, leading to complications.

Observation:

• Two cases illustrate delayed spondylodiscitis diagnosis: an elderly woman with initial urosepsis symptoms and a man with olecranon bursitis and sepsis.
• Both patients eventually presented with severe back pain, and imaging revealed spondylodiscitis with abscess formation in one case.

Findings:

• A gram-positive streptococcus infection was identified in the first patient, treated successfully with antibiotics.
• The second patient's persistent sepsis led to the diagnosis of extensive spondylodiscitis and abscess, requiring surgical intervention and antibiotics.

Implications:

• Spondylodiscitis should be suspected in patients with localized back pain, especially with fever, elevated ESR, and risk factors like advanced age, diabetes, immunosuppression, or rheumatoid arthritis.
• Prompt diagnosis and appropriate treatment (antibiotics, surgery) are crucial for managing spondylodiscitis and preventing severe complications.