Infectious spondylodiscitis presents a diagnostic conundrum, and establishing the diagnosis often requires expensive testing and workup. But because of the potentially irreversible neurologic consequences and the great expense and time required to adequately treat this rare infection, establishing a diagnosis is paramount. Below, we present a representative case from clinical practice and examine the prevalence of certain signs and symptoms and the utility of various diagnostic modalities health care providers can use to accurately diagnose afflicted patients and avoid disastrous complications.