30th July 2020

A patient is brought into the Emergency Department with severe back pain

A patient is brought into the Emergency Department with severe back pain. Magnetic resonance imaging (MRI) has shown features suggestive of discitis secondary to active infective endocarditis. Over the course of his treatment in hospital, he begins to develop some problems with movement and sensation.

He has impaired knee extension, foot inversion and dorsiflexion, reduced patella reflex, positive femoral stretch test and reduced sensation over the knee. Based on these neurological findings, where would you expect the lesion to be?

Which of the following is the most likely cause?

Select the SINGLE most appropriate option from the list below. Select ONE option only.