{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T07:30:55Z","timestamp":1771659055693,"version":"3.50.1"},"reference-count":12,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,11,3]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:p>A 44-year-old male person with tetraplegia (C-5 AIS\u2014A (American Spinal Cord Injury Association Standard Neurological Classification of Spinal Cord Injury Impairment Scale)) developed urinary tract infection and received appropriate antibiotic. Subsequently, he started sweating and shivering when he was sitting up; these symptoms resolved while lying on his back. Autonomic dysreflexia triggered by truncal movements continued to occur for 3 months. CT of the spine showed L5\u2013S1 discitis. MRI of the spine showed diffuse marrow oedema in L5 and S1 vertebrae and a large abscess at L5\/S1 level. Blood culture yielded <jats:italic>Serratia marcescens<\/jats:italic> sensitive to meropenem. Meropenem followed by ertapenem was given for 12 weeks. After 11 months, MRI showed resolution of discitis and epidural collection. The patient was able to sit up for 9\u2009hours without developing autonomic dysreflexia. If a person with cervical spinal cord injury develops posture-related autonomic dysreflexia (eg, in sitting position, lying on sides or while hoisted), disco-vertebral pathology should be suspected.<\/jats:p>","DOI":"10.1136\/bcr-2020-238202","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:13:39Z","timestamp":1678752819000},"page":"e238202","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Discitis following urinary tract infection manifesting as recurrent autonomic dysreflexia related to truncal movements in a person with tetraplegia"],"prefix":"10.1136","volume":"13","author":[{"given":"Vaidyanathan","family":"Subramanian","sequence":"first","affiliation":[{"name":"Spinal Injuries, Southport and Ormskirk Hospital NHS Trust, Southport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Hughes","sequence":"additional","affiliation":[{"name":"Radiology Department, Southport and Ormskirk Hospital NHS Trust, Southport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bakul","family":"Soni","sequence":"additional","affiliation":[{"name":"Spinal Injuries, Southport and Ormskirk Hospital NHS Trust, Southport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tun","family":"Oo","sequence":"additional","affiliation":[{"name":"Spinal Injuries, Southport and Ormskirk Hospital NHS Trust, Southport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,12,17]]},"reference":[{"key":"2025082800021133000_13.12.e238202.1","first-page":"362","article-title":"[Urogenic spondylodiscitis]","volume":"38","author":"Renker","year":"2009","journal-title":"Orthopade"},{"key":"2025082800021133000_13.12.e238202.2","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/S0003-9993(21)01693-2","article-title":"Lumbar discitis in a patient with quadriplegia: case report","volume":"70","author":"Durance","year":"1989","journal-title":"Arch Phys Med Rehabil"},{"key":"2025082800021133000_13.12.e238202.3","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1976.03630010083017"},{"key":"2025082800021133000_13.12.e238202.4","doi-asserted-by":"crossref","DOI":"10.4103\/sni.sni_287_17","article-title":"Management of autonomic dysreflexia associated with Charcot spinal arthropathy in a patient with complete spinal cord injury: case report and review of the literature","volume":"9","author":"Gibson","year":"2018","journal-title":"Surg Neurol Int"},{"key":"2025082800021133000_13.12.e238202.5","doi-asserted-by":"crossref","first-page":"16013","DOI":"10.1038\/scsandc.2016.13","article-title":"Spinal fusion and antibiotic treatment illustrating lumbar osteomyelitis and spinal instability as a previously unrecognized and surgically treatable cause of autonomic dysreflexia","volume":"2","author":"Sieg","year":"2016","journal-title":"Spinal Cord Ser Cases"},{"key":"2025082800021133000_13.12.e238202.6","first-page":"134","article-title":"Severe acute infection due to Serratia marcescens causing respiratory distress in an immunocompetent adult","volume":"54","author":"Ruiz-Sada","year":"2016","journal-title":"Rom J Intern Med"},{"key":"2025082800021133000_13.12.e238202.7","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1155\/2008\/210951","article-title":"Community-Acquired Serratia marcescens spinal epidural abscess in a patient without risk factors: case report and review","volume":"19","author":"Parkins","year":"2008","journal-title":"Can J Infect Dis Med Microbiol"},{"key":"2025082800021133000_13.12.e238202.8","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.53.1620"},{"key":"2025082800021133000_13.12.e238202.9","article-title":"Spondylodiscitis with epidural and psoas muscle abscesses as complications after transrectal ultrasound-guided prostate biopsy: report of a rare case","volume":"4","author":"Li","year":"2017","journal-title":"Eur J Case Rep Intern Med"},{"key":"2025082800021133000_13.12.e238202.10","unstructured":"The King\u2019s Fund: Ideas that change health care Edwards N . 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