Vertebral Osteomyelitis, Discitis, and Epidural Abscess: A Rare Complication of Cardiobacterium Endocarditis

Abstract

In this article, we report the case of a 75-year-old man who was presented with new low back pain for 2 weeks. His past history was significant for severe aortic stenosis necessitating bioprosthetic aortic valve placement 4 years ago, hypertension, and coronary artery disease. His physical examination was positive for point tenderness over the lower lumbar spine. He was found to be bacteremic with Cardiobacterium hominis. Magnetic resonance imaging of the spine showed lumbar (L4-L5) epidural abscess and vertebral osteomyelitis, discitis. He underwent a computed tomography–guided needle biopsy of L4-L5. The biopsy culture was also positive for Cardiobacterium hominis. A transesophageal echocardiogram showed small vegetation on the mitral valve with mild regurgitation. He was started on intravenous ceftriaxone 2 g once daily for a planned duration of 6 weeks and was discharged. However, he, unfortunately, expired at an outside facility secondary to an unknown illness 4 weeks into the treatment course.