Recurrent spondylodiscitis secondary to hallux osteomyelitis

Aleksandra Staniszewska, Elizabeth Ballingall, Peter Schnatterbeck, Christopher R Lattimer, Amit Amin, William Lynn, Sanjeev Mehta


Foot infections are the commonest complication of diabetes mellitus requiring hospitalisation. Despite local osteomyelitis being the most frequent sequel of a diabetic foot infection, there is emerging evidence to suggest that local disease may lead to distant infections. In this report we present a case of recurrent thoracic spine spondylodiscitis due to left hallux osteomyelitis in a man with type 2 diabetes. This case illustrates the importance of considering spondylodiscitis as a differential diagnosis in patients presenting with diabetic foot infection and complaining of acute severe back pain.


diabetes, foot ulcer, osteomyelitis, amputation, spondylodiscitis

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Yazdanpanah L, Nasiri M, Adarvishi S. Literature review on the management of diabetic foot ulcer. World J Diabetes 2015;6:37–53.

Ramsey SD, Newton K, Blough D, et al. Incidence, outcomes, and cost of foot ulcers in patients with diabetes. Diabetes Care 1999;22:382–7.

Jensen AG, Espersen F, Skinhoj P, Rosdahl VT, Frimodt-Moller N. Increasing frequency of vertebral osteomyelitis following Staphylococcus aureus bacteraemia in Denmark 1980–1990. J Infect 1997;34:113–18.

Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother 2010;65(Suppl 3):24.

Shaho S, Khan S, Huda MS, Chowdhury TA. Metastatic spinal abscesses from diabetic foot osteomyelitis. BMJ Case Reports 2014 Jun 11; 2014.pii:bcr2014204816. doi: 10.1136/bcr-2014-204816.

Mantovani A, Trombetta M, Imbriaco C, et al. Diabetic foot complicated by vertebral osteomyelitis and epidural abscess. Endocrinol Diabetes Metab Case Rep 2016; 2016: 150132. Published online 2016 May 18.

Toyota T. Vertebral osteomyelitis in diabetes mellitus. Intern Med (Tokyo, Japan) 1997;36:382–3.

McHenry MC, Easley KA, Locker GA. Vertebral osteomyelitis: long-term outcome for 253 patients from 7 Cleveland-area hospitals. Clin Infect Dis 2002;34:1342–50.

Skaf GS, Domloj NT, Fehlings MG, et al. Pyogenic spondylodiscitis: an overview. J Infect Public Health 2010;3:5–16.

Bozkurt F, Gulsun S, Tekin R, Hosoglu S, Acemoglu H. Comparison of microbiological results of deep tissue biopsy and superficial swab in diabetic foot infections. J Microbiol Infect Dis 2011;1:122–7.

Huang Y, Cao Y, Zou M, et al. A comparison of tissue versus swab culturing of infected diabetic foot wounds. Int J Endocrinol 2016; 2016:8198714.

Nelson A, Wright-Hughes A, Backhouse MR, et al. CODIFI (Concordance in Diabetic Foot Ulcer Infection): a cross-sectional study of wound swab versus tissue sampling in infected diabetic foot ulcers in England. BMJ Open 2018;8:e019437.

Grammatico L, Baron S, Rusch E, et al. Epidemiology of vertebral osteomyelitis (VO) in France: analysis of hospital-discharge data 2002–2003. Epidemiol Infect 2008;136:653–60.

Bhagat S, Mathieson C, Jandhyala R, Johnston R. Spondylodiscitis (disc space infection) associated with negative microbiological tests: comparison of outcome of suspected disc space infections to documented non-tuberculous pyogenic discitis. Br J Neurosurg 2007;21:473–7.

Lu YA, Hsu HH, Kao HK, et al. Infective spondylodiscitis in patients on maintenance hemodialysis: a case series. Renal Failure 2017;39:179–86.



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