[Fosfomycin in the treatment of recurrent spondylodiscitis].

Abstract

The presented case report illustrates a complicated clinical course of recurrent spondylodiscitis in a 60-year-old patient newly diagnosed with HIV infection. Initially delayed diagnosis due to non-specific symptoms and misleading radiological findings resulted in recurrent hospitalizations complicated by pneumonia, respiratory failure, spinal epidural abscess and the need for neurosurgical intervention. Antibiotic therapy was gradually modified and lasted a total of 164 days. Ultimately, the combination of fosfomycin and flucloxacillin administered over a period of 62 days led to resolution of psoas abscesses and normalization of spinal findings on magnetic resonance imaging. This case highlights the potential of fosfomycin as part of combination therapy for difficult-to-treat or recurrent vertebral infections caused by Staphylococcus aureus, particularly in patients with underlying HIV infection.