title: Bacteroides fragilis vertebral osteomyelitis secondary to anal dilatation.
abstract: METHODS
  A case report of anaerobic vertebral osteomyelitis after anal dilatation.
  
  
  OBJECTIVE
  To present a patient with monomicrobial anaerobic vertebral osteomyelitis secondary to a previously undescribed source of infection.
  
  
  BACKGROUND
  A 17-year-old boy presented with low back pain 3 months after anal dilatation.
  
  
  METHODS
  Physical examination, technetium-99m bone scan, plain radiograph, CT, and MRI studies of the lumbar spine were used to clinically diagnose lumbar osteomyelitis. Culture material from the involved disc was positive for Bacteroides fragilis.
  
  
  RESULTS
  The patient recovered after 8 weeks of treatment with oral metronidazole.
  
  
  CONCLUSIONS
  Bacteroides fragilis hematogenous osteomyelitis is a rare entity. This is the first reported case of such disease after anal dilatation.
authors.affiliation: Infectious Diseases Unit Ha'Emek Medical Center, Afula, Israel. raz_r@clalit.org.il
authors.forename: B
authors.initials: B
authors.lastname: Chazan
authors.forename: J
authors.initials: J
authors.lastname: Strahilevitz
authors.forename: M A
authors.initials: MA
authors.lastname: Millgram
authors.forename: S
authors.initials: S
authors.lastname: Kaufmann
authors.forename: R
authors.initials: R
authors.lastname: Raz
mesh_terms: D000293:Adolescent; D001442:Bacteroides Infections / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D001441:Bacteroides fragilis / Q000302:isolation & purification*; D004106:Dilatation / Q000009:adverse effects*; D005401:Fissure in Ano / Q000628:therapy*; D006801:Humans; D017116:Low Back Pain / Q000382:microbiology / Q000473:pathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D010019:Osteomyelitis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed
chemical_list: D008795:Metronidazole