Clinical Case Database / Category: Patient Management

Discitis: the cause of a PUO

Publication details

Ian C Bickle MB, BCh, BAO (Hons), FRCR, Asma Lina Fazlanie BMedSci (Hons)
Foundation Years Journal, volume 3, issue 8, p.13 (123Doc Education, London, October 2010)


A 69-year-old gentleman was admitted with a presumed lower respiratory tract infection (LRTI) for which he received treatment on a general medical ward. After a failure to respond to first line antibiotic therapy, the clinical assumption was inferred that this was due to infection with an atypical organism. On deeper clinical questioning the patient revealed mild back pain of short duration that commenced following a recent camping trip. After an unsuccessful response to numerous antimicrobials, investigations were initiated for a pyrexia of unknown origin (PUO). After multiple negative investigations, including plain films of the lumbar spine, a radioisotope (indium) WCC scan was performed.

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Ian C Bickle MB, BCh, BAO (Hons), FRCR

Radiology SpR
Sheffield Hospitals Trust
Royal Hallamshire Hospital
Glossop Rd
S10 2JF

Asma Lina Fazlanie BMedSci (Hons)

University of Sheffield Medical Student


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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