Abstract
A 54-year-old man with poorly controlled type 2 diabetes was admitted to our hospital because of persistent lumbago accompanied by a fever. Laboratory data showed leucocytosis (12, 800/μl), a positive CRP (17.6 mg/dl) and an elevated ESR (115 mm/h). A lateral X-ray of the lumbar spine revealed a narrowing of the L 2/3 intervertebral disk space. T2-weighted magnetic resonance imaging revealed high signal intensity lesions in the posterior portion of the vertebral bodies of the L 2 and L 3 vertebrae and the L 2/3 intervertebral disk. Gallium and bone scintigraphies showed a markedly increased uptake in the L 2/3 area. Streptococcus intermedius was isolated from the venous blood. We diagnosed the patient as having pyogenic vertebral osteomyelitis as a result of a Streptococcus intermedius infection associated with diabetes. Clinical symptoms improved following treatment with insulin and antibiotics. Streptococcus intermedius is a rare causative organism in osteomyelitis, but the incidence of infections resulting from Streptococcus intermedius may increase in the near future. Diabetic patients infected with Streptococcus intermedius should be treated with antibiotics and a strict control regimen for thier diabetes.
