Lumbosacral Discitis and Vertebral Osteomyelitis Caused by ESBL-Producing Escherichia coli in an Immunocompetent Patient.

Abstract

Discitis and vertebral osteomyelitis are rare spinal infections that are difficult to diagnose due to nonspecific presentations. This case report describes a 62-year-old immunocompetent female presenting with recurrent lower back pain and imaging findings concerning for lumbosacral discitis. Initial cultures and biopsy were inconclusive, but surgical intervention confirmed vertebral osteomyelitis caused by an extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. The patient responded well to targeted carbapenem therapy and was placed on chronic suppressive treatment with minocycline. Our case highlights the diagnostic challenges of lumbosacral discitis and the importance of considering multidrug-resistant, gram-negative pathogens even in low-risk patients.