Black disc morphology during routine lumbar discectomy with subsequent diagnosis of enterococcal discitis

BACKGROUND: Enterococcus faecalis is reported infrequently as an infectious cause of discitis. In the literature, the diagnosis is commonly made based on the clinical picture coupled with blood cultures, imaging, and tissue cultures. CASE DESCRIPTION: A 62-year-old male with chronic lower back pain underwent lumbar decompression for a lumbar disc. At surgery, the patient had significant black discoloration of the disc material. Later, the cultures demonstrated E. faecalis infectious discitis. CONCLUSION: Here is an example of enterococcal lumbar discitis found during a routine lumbar discectomy. As operative cultures revealed E. faecalis, the patient required not one but two operations (i.e., second for seroma/ hematoma due to infection) following which antibiotic therapy eradicated the infection.