amoxicillin-potassium-clavulanate-combination and Back-Pain

A case report.. To report an unusual case of spondylodiscitis with multiple level involvement.. Spondylodiscitis, an infection of the intervertebral disc space, vertebral bodies, or the paraspinal epidural space can be a serious disease because of diagnostic delay and inadequate treatment.. A previously healthy, 52-year-old man was presented to our outpatient clinic with a complaint of acute, atraumatic onset of severe back pain for more than 1 month. Initially, he was misdiagnosed at another clinic as myofascial pain and treated with nonsteroidal anti-inflammatories and physical therapy, which he did not benefit from. He never complained of fever; however, laboratory tests revealed raised erythrocyte sedimentation values, increased C-reactive protein values but normal leukocyte count. Thoracal and lumbal plain radiographs were nonspecific. Magnetic resonance imaging demonstrated increased signal intensity in vertebral bodies and intervertebral disc space through T12-L4 and in the paravertebral musculature at L2-L3 with contrast enhancement. Blood cultures and computed tomography-guided needle biopsy and cultures were negative.. The patient was treated with oral amoxicillin and clavulanate and responded very well clinically; however, imaging examinations were repeated up to 6 months because of multilevel involvement. Follow-up magnetic resonance imaging findings at 3 months and 6 months showed decreased signal intensity, and luckily, there was no evidence of vertebral destruction.. Diagnosis of spondylodiscitis could be challenging and commonly missed; however, it should always be included in the differential diagnoses of back pain in the middle aged and healthy population.

Topics: Administration, Oral; Amoxicillin-Potassium Clavulanate Combination; Back Pain; Biomarkers; Biopsy; Blood Sedimentation; C-Reactive Protein; Discitis; Humans; Leukocyte Count; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Middle Aged; Severity of Illness Index; Thoracic Vertebrae; Tomography, X-Ray Computed; Treatment Outcome

Emphysematous pyelonephritis is a necrotizing renal infection characterized by bacterial gas production in the renal and perirenal area. It is a rare infection diagnosed in diabetic patients in most cases. Emphysematous pyelonephritis has a high mortality rate. We herein report one case of bilateral emphysematous pyelonephritis managed by medical therapy alone.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Back Pain; Bacteremia; Bacteriuria; Consciousness Disorders; Diabetes Mellitus, Type 2; Emphysema; Female; Fever; Humans; Klebsiella Infections; Middle Aged; Pyelonephritis; Remission Induction