An atypical spondylodiscitis: case report

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Lilian Sousa
Diana Moura
Vera Frazão Vieira
Susana Travassos Cunha
João Santos

Resumo

Spondylodiscitis is a rare pathology, however its incidence has been rising in recent years. Its signs and symptoms are nonspecific therefore the diagnosis may be delayed from 2 to 6 months. The main symptom is back or neck pain but some patients may experience no pain. The authors report the case of an 82 year old man with a presentation of initial cough, followed by monoarthritis, then polyarthritis and finally paraparesis, accompanied by fever and elevation of infection markers. The insidious evolution delayed the diagnosis of spondylodiscitis as well as its treatment. The identified pathogen was Streptococcus pneumoniae, a very rare cause of spondylodiscitis. After 6 weeks of antibiotics the patient was discharged. Spondylodiscitis diagnosis requires a high level of suspicion due to its wide range of clinical presentations and must be ruled out when we are faced with a fever of unknown origin or an inappropriate response to treatment.

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