Vertebral Osteomyelitis

Abstract

A 57-year-old man presents 2 weeks after prostate biopsy with fever, chills, and new lumbar back pain. His temperature is 39.7°C; he has an enlarged, tender prostate and lumbar spine tenderness. His white-cell count is 9100 per cubic millimeter, and the C-reactive protein level is 343 mg per liter. Urine and blood cultures reveal multidrug-resistant extended-spectrum β-lactamase-producing Escherichia coli susceptible to imipenem. How should he be evaluated and treated?