Atipična prezentacija spondilodiscitisa izazvanog meticilin-senzitivnim sojem bakterije Staphylococcus aureus – prikaz slučaja.

To present the atypical clinical and radiological findings of methicillinsensitive strain of Staphylococcus aureus (MSSA) spondylodiscitis and emphasize the importance of early diagnosis to assure timely targeted therapeutic approach and avoid complications, primarily epidural and paravertebral inflammatory collections. Case report: We present the case of a patient (age 77) admitted to the emergency hospital admission with a non-specific clinical symptom of sharp abdominal pain spreading towards the back lasting for 7-8 days, followed by a sudden onset of paraplegia. A clinical examination revealed loss of sensation from the level of the ninth thoracic vertebra downwards and loss of sphincter control. Considering the history of abdominal aortic aneurysm surgery, a CT aortography was performed, which demonstrated a pathological process involving the seventh (Th7) and eighth (Th8) thoracic segments with completely preserved bone structure of the vertebra and extensive paravertebral soft tissue mass. An urgent MRI of the thoracic spine showed extensive bone marrow oedema of Th7 and Th8 vertebra, likely inflammatory in nature, and large epidural collection resulting in compressive myelopathy. During the subsequent surgical decompression of the spinal canal no typical macroscopical markers of inflammation were observed and the suspicion of tumor process was raised. The pathohistological and microbiological analysis of the surgical specimens did not confirm malignant tumor infiltration. The MSSA was isolated from hemoculture. The future clinical course was complicated by pneumonia and unfortunately the patient died 6 weeks after starting the treatment. Conclusion: The diagnosis of spondylodiscitis is often challenging due to a wide range of clinical and morphological findings requiring high index of suspicion, especially in elderly patients with comorbidities due to risk of developing complications and fulminant course of the disease. [ABSTRACT FROM AUTHOR]