Spontaneous spondylodiscitis caused by Klebsiella oxytoca

Spontaneous infectious spondylodiscitis (SIS) is an uncommon cause of low back pain in adults1 being most commonly described in children. Most cases in adults follow spinal treatment, and adult cases unrelated to previous spinal surgical procedures are considerably less common. In contrast with postoperative patients, in whom the most common infecting organisms isolated were Staphylococcus aureus and Staphylococcus epidermidis , a wide variety of infectious agents have been implicated in SIS, including Klebsiella species.1–5 Klebsiella oxytoca is a non-motile, Gram negative bacillus, that can be differentiated from Klebsiella pneumoniae by its inability to produce indole from tryptophan.6 As far as we know, this is the first case of SIS caused by K oxytoca to be reported. A 51 year old man with an antecedent of intravenous heroin addiction and two months' history of progressive thoracolumbar pain without fever was referred for investigation. Physical examination showed mild tenderness to palpation over D12-L1 and a painful paravertebral musculature contraction that limited movements of the back. Motor examination and deep tendon reflexes were normal. Several skin ulcers and venepuncture lesions in arms, hands, and legs were seen. The remainder …