Recurrent Spondylodiscitis in a Cirrhotic Scuba Diving Instructor

Henin, Guillaume [UCL] DELIRE, Bénédicte [UCL] MAROT, Jean-Christophe DE GHELLINCK D'ELSEGHEM VAERN Léopold [UCL] Dahlqvist, Géraldine [UCL]

Spondylodiscitis is a challenging infection in cirrhotic patients. Liver dysfunction makes the course of the infection more aggressive. We report the case of a 56-year-old man with a medical history of abstinent alcoholic cirrhosis and repeated infectious events including cervical abscess. He had been scuba diving instructor for 20 years. He presented to the emergency room for chills, rigor, and high temperature. A Citrobacter freundii prostatitis was identified and treated. Then he reported mechanical lower back pain persisting despite analgesia. MRI of the lumbar spine demonstrated L5/S1 spondylodiscitis with an unusual signal modification of S1 vertebral body. This case enlightens the high susceptibility to bacterial infections in cirrhosis. Special attention should be given in patients who scuba dive regularly in case of bacteremia with back pain.