Intervertebral disc space infection: another low back syndrome of the young.

Pyogenic disc space infection is a rare and unappreciated cause of low back pain. Reported herein is a young man with chronic low back pain and the HLA-B27 antigen which initially led to the diagnosis of ankylosing spondylitis. However, serial lumbar radiographs and bone scan established an inflammatory lesion involving the L2-L3 intervertebral disc space, and persistently normal sacroiliac joints. A needle biopsy and culture of the disc space yielded Staphylococuss aureus. Treatment with antibiotics, bed rest and back bracing resulted in a complete resolution of symptoms and healing of the vertebral lesion. It is the purpose of this report to review the clinical, laboratory and radiographic features of intervertebral disc space infection as well as pitfalls in its diagnosis.