Infective discitis with Neisseria sicca/subflava in a previously healthy adult

Study design: A case report of Neisseria sicca/subflava discitis in a healthy elderly female. Objective: To report a rare case, which is usually seen exclusively in children. Setting: Stoke on Trent, England. Method: Case report, a 65-year-old female with a 6 month history of back and bilateral leg pain. X-rays showed collapse of L4/5 disc. No neurological deficit. Magnetic resonance imaging supported the clinical suspicion of discitis. Percutaneous biopsy followed 2 weeks later by open biopsy with bilateral root decompression was performed. Culture of L4/5 disc tissue produced Neisseria sicca/subflava. The patient was treated with a 4-week course of intravenous amoxycillin. Follow-up at 3 months confirmed clinical resolution of original symptoms. Conclusion: Any organism cultured from biopsy needs to be interpreted within the context of the clinical case. If clinical suspicion is high, further weight must be added to the finding of unusual or environmental organisms and culture of a repeat aspirate or biopsy may clarify the significance.