Enterobacter agglomerans spondylodiscitis - A possible, unrecognized complication of tetracycline therapy

Study Design. This case report describes infection in a lumbar disc in a he althy young man with an organism of low pathogenicity. The patient was taki ng a prolonged course of antibiotics at the time the infection occurred. Objective. To describe this unique case of infective spondylodiscitis. Summary of Background Data. To the authors' knowledge, spinal infection wit h Enterobacter agglomerans has never been reported. This organism is a tran sient gut colonizer, and may have established itself secondary to the patie nt's prolonged ingestion of tetracycline for acne. Methods. This 22-year-old farmer had spontaneous lumbar back pain. Radiolog ic investigations showed an abnormality in the L4-L5 disc region, and toget her with other investigations, were suggestive of infection. The diagnosis was confirmed by surgical aspiration. Results. Antibiotic therapy was administered, and the patient made a comple te recovery. Follow-up radiographs showed a complete loss of the L4-L5 disc space with only minimal bone destruction. Conclusion. A unique cause of infective lumbar discitis is presented. Sever al features of this case are unusual. The magnetic resonance findings were not readily diagnostic. The cultured organism is usually nonpathogenic. The infection may have been secondary to prolonged tetracycline therapy.