Enterococcal Diskitis

Abstract

We describe 2 patients diagnosed with enterococcal vertebral spondylodiskitis, leading to the unsuspected diagnosis of endocarditis in one. Because of high-level aminoglycoside resistance, 1 patient received a 6-week course of ampicillin and ceftriaxone, whereas the other received standard ampicillin and gentamicin treatment. Both patients recovered. Review of the literature revealed only 20 previously reported cases with enterococcal diskitis. Of the 20 patients for whom data on sex were available, 14 were men, and 6 were women; the mean age at diagnosis was 67 ± 8 years; all experienced back pain, but only 10 had low-grade fever. Thirteen (59%) of these 22 patients were diagnosed with endocarditis. Only 4 patients underwent diskectomy, and 3 other patients required transcutaneous drainage; all received prolonged intravenous antibiotic treatment, consisting of ampicillin and gentamicin in the majority. Of the 21 patients for whom outcome was available, 17 (81%) recovered, and 4 patients died.