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Streptococcus viridans osteomyelitis with endocarditis presenting as acute onset lower back pain
1Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California.
The Journal of Emergency Medicine
|May 1, 1990
Summary
Pyogenic vertebral osteomyelitis can present acutely, even with uncommon bacteria like viridans Streptococcus. Consider this diagnosis in patients with sudden lower back pain and fever.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Radiology
Background:
- Pyogenic vertebral osteomyelitis (PVO) is often a chronic condition.
- Viridans Streptococcus is an uncommon cause of PVO.
Observation:
- An elderly male with diabetes mellitus and recent dental work presented with acute lumbosacral pain and fever.
- CT and MRI scans suggested pyogenic vertebral osteomyelitis.
Findings:
- Gallium scanning and blood cultures confirmed viridans Streptococcus vertebral osteomyelitis.
- Viridans Streptococcus infections typically present with acute back pain.
Implications:
- PVO should be considered in emergency department patients with acute lower back pain, fever, leukocytosis, and elevated ESR.
- This case highlights the potential for acute PVO presentation, even with less common pathogens.
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