Question

A patient with a hemodialysis catheter has fever, back pain, elevated ESR&CRP, imaging showing T12-L1 vertebral body DESTRUCTION w/disk-space narrowing. Blood culture reveals gram-positive cocci in clusters. IV antibiotics started. What is the diagnosis and next step?

a) Osteomyelitis; spinal immobilization
b) Septicemia; surgical debridement
c) Vertebral osteomyelitis; neurosurgical consultation
d) Discitis; antibiotic course continuation

Answer 1

c) Vertebral osteomyelitis; neurosurgical consultation

The diagnosis is Vertebral osteomyelitis. The next step would be neurosurgical consultation.

Step-by-step explanation:

The diagnosis for the patient in this case is Vertebral osteomyelitis. The patient exhibits symptoms such as fever, back pain, elevated ESR & CRP, and imaging showing vertebral body destruction with disk-space narrowing. The blood culture revealing gram-positive cocci in clusters further supports the diagnosis. The next step would be neurosurgical consultation to evaluate the extent of the infection and determine the appropriate treatment plan.