<i>Aerococcus urinae</i> Spondylodiscitis: A Case Report and Review of the Literature

<b>Background:</b> <i>Aerococcus urinae</i>, a rare human pathogen, mainly causes urinary tract infection, endocarditis, and bacteremia. However, it is rarely the cause of other types of infection such as spondylodiscitis. Invasive <i>A. urinae</i> infection chiefly occurs in older men with underlying urinary tract disorders. The real incidence may be underestimated, as <i>Aerococci</i> grow in a CO2-containing atmosphere, and urine cultures are usually not incubated in this environment. There have been eight case reports of spondylodiscitis due to <i>A. urinae.</i> <b>Material and Methods:</b> We report a 9^th case occurring in an 80-year-old Caucasian man with lower back pain. The patient had predisposing conditions (diabetes and a history of urological surgery). Spinal MRI showed signs of spondylodiscitis. Two computed tomography-guided biopsies targeting the intervertebral disc and psoas muscle were not diagnostic. One of 10 blood culture bottles grew <i>A. urinae</i>. <b>Results:</b> After worsening of an L2 fracture, and unsuccessful percutaneous sampling procedures, the patient underwent surgical stabilization of T12 to L4 with multiple biopsies. Biopsy cultures grew <i>Aerococcus urinae</i>. Amoxicillin was administered intravenously for 14 days, followed by oral levofloxacin for 3 months. <b>Conclusion:</b> <i>A. urinae</i> should be considered in spondylodiscitis with negative cultures, particularly in older men with diabetes and urological conditions.