Rapid Onset Erysipelothrix Rhusiopathiae Spondylodiscitis with Bacteraemia and Psoas Abscess – A Case Report

Background: Erysipelothrix rhusiopathiae is a Gram-positive bacillus. Human Infections occurs principally as a result of contact with animals, their products or wastes. It is of three forms, a mild cutaneous erysipeloid, a diffuse cutaneous form and a rare serious form with systemic complications, septicaemia and endocarditis. We report a 74-year-old woman presented with septic form of E. rhusiopathiae spondylodiscitis and psoas abscess. After surgical decompression, and appropriate antibiotics, patient completely resolved from the illness. Though cases of E. rhusiopathiae spondylodiscitis were previously described, our case has two unique key factors: the patient does not fit to contact with any animals and she does not have any medical co-morbidities. Case Presentation: A 74-year-old woman presented with acute onset low back pain with high grade fever numbness, paraesthesia and radiating pain to the right lower limb. Her WBC count, ESR and CRP were high suggestive of early sepsis. MRI correlated with abscess at L2-L3 disc with significant canal stenosis and psoas abscess. She underwent spinal decompression and abscess drainage sent for culture reported as Erysipelothrix rhusiopathiae and sensitive to Ceftriaxone. Conclusion: Erysipelothrix rhusiopathiae was under-diagnosed because of its resemblance with other infections. It is hard to clinically diagnose without the aid of laboratory testing in the absence of animal exposure and in patients without identifiable risk factors like our patient. High index of suspicion with prompt and careful microbiological investigations would help in such rare presentations.