An unusual cause of non-weight bearing

摘要

A 13-month-old girl presented with refusal to weight bear and walk for 2 weeks. She was refusing to sit or lie on her back. She was sleeping prone. She was able to crawl. There was no history of trauma. She was opening her bowels normally. Two weeks before admission, she had upper respiratory tract infection treated with antibiotics. Her birth and neonatal period were uneventful. Developmental milestones were normal. She started walking independently at 12 months. General and neurological examinations were unremarkable. Blood investigations revealed an elevated erythrocyte sedimentation rate (ESR) of 75, normal C reactive protein, normal creatine kinase and a white cells count of 14X10~9. She had a MRI spine (figure 1) which showed increased T2 signal of L3/L4 vertebral bodies with near total obliteration of disc space. Discitis was diagnosed. She was conservatively managed with intravenous cefuroxime for 7 days followed by 5 weeks of oral cefuroxime. She made a good recovery.