Streptococcus Intermedius Spondylodiscitis: An Unusual Presentation of Acute Back Pain in an Elderly Gentleman With Parkinsons Disease

Wahid Abdul, Amy Jones, Preeti Gupta


Back pain is a common problem affecting approximately one-third of the UK adult population each year with the etiology in older people commonly attributed to osteoporosis and spondylosis. Uncommon causes, such as spondylodiscitis, can potentially cause significant complications, therefore early diagnosis and management are imperative. We present an unusual case of back pain in an elderly gentleman with Parkinsons disease (PD) attributed to Streptococcus intermedius spondylodiscitis. A 73-year-old gentleman presented with non-specific chest and abdominal pain. Inflammatory markers were elevated, consolidation demonstrated on chest X-ray, and antibiotics were commenced. Patient suffers from PD managed with selegiline, stalevo, and a self-administered apomorphine subcutaneous pump. He developed a constant severe lower back pain without neurological deficit. Streptococcus intermedius was identified on blood culture and common sources were excluded. Magnetic resonance imaging and minimal-preparation computed tomography (CT) confirmed intervertebral spondylodiscitis. A conservative approach with combination antibiotics and rehabilitation was undertaken and the patient returned to his previous functional level. We report an unusual case of spondylodiscitis in an elderly gentleman with PD. The initial presentation of radicular pain, unusual causative agent isolated, and the likely source of infection from the apomorphine pump highlight the importance of clinical suspicion, early diagnosis and management of patients with spondylodiscitis.

J Med Cases. 2013;4(12):789-791


Streptococcus intermedius; Spondylodiscitis; Elderly; Parkinsonís disease

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.