A case of pyogenic spondylodiscitis caused by methicillin-resistant Staphylococcus aureus in a 12-year-old girl

Abstract

Pyogenic spondylodiscitis is a rare disease; methicillin-resistant Staphylococcus aureus (MRSA)-associated cases in children are even rarer. We present a case of pyogenic vertebral osteomyelitis diagnosed using magnetic resonance imaging (MRI) in which MRSA was the suspected causative agent. A 12-year-old girl arrived at our hospital complaining of back pain and fever. Blood tests revealed mild inflammation, with MRI revealing lesions of the L1/L2 vertebrae and intervertebral disks, and she was diagnosed with pyogenic spondylodiscitis. MRSA was found in the patient’s blood culture, and vancomycin hydrochloride was administered to the patient for 6 weeks. Her back pain and fever quickly subsided, and the symptoms did not recur. Although the patient was successfully treated with conservative therapy alone, other adult MRSA-related cases are nonresponsive to conservative treatment and therefore, require surgery. Given that the diagnosis of pyogenic spondylodiscitis can be difficult in some cases due to its nonspecific symptoms and blood test findings, it should be considered in the differential diagnosis for patients who present with fever and back pain.