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A 56-year-old man presented with severe lumbar pain, a seven-week history of fever (temperature as high as 39°C), a 10-kg weight loss, and a recent history of treatment with cephalosporins. He had a herniated L4–L5 intervertebral disk and hypertensive heart disease with a dilated left ventricle, reduced left ventricular function, and mild-to-moderate mitral regurgitation. Examination disclosed a grade 3/6 holosystolic murmur and evidence of sciatica. The serum level of C-reactive protein (12.1 mg per deciliter) and the leukocyte count (15,400 per cubic millimeter) were elevated. Blood cultures were negative. Lumbosacral magnetic resonance imaging and scintigraphy showed no specific findings. The . . . [Full Text of this Article] |
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