The Brief Case: A Variant on a Classic-Abiotrophia defectiva Endocarditis with Discitis.

Abstract

A 79-year-old man with a medical history of hypertension presented to the hospital with acute-on-chronic back pain. Ten weeks prior to presentation, he developed severe, persistent lower back pain while working on a construction project, which progressed until he required a cane and ultimately a walker for mobility. He had previously been active with construction projects, biking, and hiking. Two weeks prior to presentation, he was evaluated by a neurosurgeon, and magnetic resonance imaging (MRI) revealed L4-L5 disc enhancement, which was concerning for discitis. An outpatient vertebral bone biopsy was planned, but due to worsening pain, he presented to the emergency department for expedited evaluation.