Spontaneous corynebacterium discitis in a patient with chronic renal failure.
METHODS
Case report describing spontaneous Corynebacterium diptheria discitis in a patient with chronic renal failure.


OBJECTIVE
To describe this very rare form of discitis and the results of surgical and antibiotic therapy.


METHODS
University Department of Neurosurgery, Turkey.


METHODS
A 55-year-old man with chronic renal failure presented with acute low-back pain. Lumbar magnetic resonance imaging (MRI) suggested discitis and osteomyelitis at the L5-S1 level. The L5-S1 disc was operated upon and the discectomy material was sent for pathological and microbiological analysis.


RESULTS
Pathological examination revealed infection and bacterial culture grew C. diptheria. The patient was prescribed combination antibiotic therapy with vancomycin, a third-generation cephalosporin, and rifampicin. Clinical status improved after 8 weeks of therapy. Lumbar MRI revealed remission of the discitis and osteomyelitis after 10 months of follow-up.


CONCLUSIONS
Chronic renal failure patients with low-back pain should be investigated for spinal infection. These individuals are prone to low-grade infection in the form of discitis or osteomyelitis. Corynebacterium subspecies rarely cause spontaneous discitis. This case is interesting because of the unusual causal organism and the occurrence of discitis in the setting of chronic renal failure.
Atalay
B
B
Department of Neurosurgery, Başkent University Faculty of Medicine, Ankara, Turkey.
Ergin
F
F
Teksam
M
M
Caner
H
H
Altinörs
N
N
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D003354:Corynebacterium Infections / Q000150:complications*; D003353:Corynebacterium diphtheriae; D003937:Diagnosis, Differential; D015299:Discitis / Q000150:complications* / Q000382:microbiology* / Q000628:therapy; D017586:Diskectomy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D017116:Low Back Pain / Q000209:etiology; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012293:Rifampin / Q000627:therapeutic use; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D014640:Vancomycin; D012293:Rifampin