Multidrug-resistant Pneumococcus causing vertebral osteomyelitis

Primary vertebral osteomyelitis is a rare presentation of pneumococcal infection especially in an asymptomatic patient with no primary focus of infection. This report describes a patient who presented with lower back pain in which the magnetic resonance imaging showed little evidence of L1 and L2 vertebral body destruction. Cultures from these vertebral bodies grew penicillin and third-generation resistant pneumococcus. The patient was treated successfully with 6 weeks of vancomycin and rifampin.