Lumbar spondylodiscitis attributed to a rare infection with Actinomyces Neuii in a diabetic patient: Imaging findings and clinical follow-up.

Spondylodiscitis describes an infection of the vertebral body and disc. Clinical presentation is often nonspecific. As a result, imaging plays a crucial role in establishing the diagnosis. The most common associated organism is Staphylococcus aureus. Actinomyces neuii is a gram-positive rod that is primarily known to cause soft tissue infections but has rarely been described in association with spondylodiscitis. At the time of this publication, only 1 other case of A. neuii has been reported in the literature. We present a case report of a diabetic patient diagnosed with spondylodiscitis with cultures demonstrating A. neuii as the most likely causative organism. In our case, no definitive infectious source was identified. The significance of A. neuii spondylodiscitis is unclear. At 1 year follow up, this patient had been successfully treated with antibiotic therapy, but did suffer from significant chronic back pain attributed to the infection. Finally, our case highlights important clinical and imaging findings that may illustrate the elusive nature of this diagnosis.