Enterococcus osteomyelitis secondary to pyelonephritis

We report a case of enterococcus lumbar osteomyelitis that developed after post-operative pyelonephritis. A 78-year-old G2P2 with Stage III uterovaginal prolapse and genuine stress urinary incontinence who underwent laparoscopic-assisted vaginal hysterectomy, high uterosacral ligament suspension, tension-free vaginal tape-obturator approach, and cystoscopy presented with post-operative back pain. Work-up of her back pain revealed enterococcus pyelonephritis. She continued to have back pain despite outpatient antibiotic treatment and further work-up revealed enterococcus lumbar osteomyelitis at the level of L1-L2. Enterococcus vertebral osteomyelitis is a rare infection that can occur by hematogenous spread from an infection of the urinary tract.