Escherichia coli bacteremia leading to quadriparesis due to delayed diagnosis of multifocal spondylodiscitis: a case report and literature review.

Abstract

Spondylodiscitis is a life-threatening neurological condition that, if not diagnosed early, can lead to severe complications, including progressive neurological deterioration. Diagnosis involves clinical evaluation, imaging, and microbiological testing. Delayed recognition, advanced age, virulent pathogens, and comorbidities increase the risk of poor outcomes. We report the case of a middle-aged male with diabetes, hypertension, and chronic kidney disease who developed noncontiguous multifocal spondylodiscitis. Initially presenting with progressive neck pain and urinary tract infection, his condition worsened over 3 months, resulting in lower limb weakness, bladder and bowel dysfunction, and quadriparesis. MRI spine revealed spinal infections at multiple levels and extended-spectrum beta-lactamase Escherichia coli in cultures. He underwent meropenem treatment, surgical decompression, and spinal fusion. Despite C6 quadriparesis, intensive rehabilitation enabled him to walk with assistance and achieve partial independence in daily activities within 6 months. This case underscores the necessity of early diagnosis, proper management, and long-term rehabilitation for optimal recovery.