1887

Abstract

Here, we present a case of polymicrobial anaerobic spondylodiscitis.

A forty-five year-old female patient was referred to a specialist orthopaedic hospital with an eight week history of back pain without fevers. X-ray imaging and magnetic resonance imaging showed acute osteomyelitis of the twelfth thoracic and first lumbar vertebrae. Prolonged enrichment cultures grew and , identified by matrix-assisted laser desorption ionisation-time of flight (MALDI-ToF) mass spectrometry (MS). The patient was successfully treated with six weeks of intravenous ertapenem and oral clindamycin.

Anaerobic discitis is rare, and polymicrobial discitis is rarer still. A PubMed literature review revealed only seven cases of discitis and only twelve cases of discitis; this includes only one other reported case of a polymicrobial discitis due to infection with both anaerobes. We emphasise the importance of prolonging enrichment culture and the use of fast yet accurate identification of anaerobes using MALDI-ToF MS in these infections.

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2017-04-12
2020-09-30
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References

  1. Grammatico L, Baron S, Rusch E, Lepage B, Surer N et al. Epidemiology of vertebral osteomyelitis (VO) in France: analysis of hospital-discharge data 2002-2003. Epidemiol Infect 2008;136:653–660 [CrossRef][PubMed]
    [Google Scholar]
  2. Citron DM. Update on the taxonomy and clinical aspects of the genus Fusobacterium. Clin Infect Dis 2002;35:S22–S27 [CrossRef][PubMed]
    [Google Scholar]
  3. Dufour V, Feydy A, Rillardon L, Redondo A, Le Page L et al. Comparative study of postoperative and spontaneous pyogenic spondylodiscitis. Semin Arthritis Rheum 2005;34:766–771 [CrossRef][PubMed]
    [Google Scholar]
  4. Sans N, Faruch M, Lapègue F, Ponsot A, Chiavassa H et al. Infections of the spinal columnspondylodiscitis. Diagn Interv Imaging 2012;93:520–529 [CrossRef][PubMed]
    [Google Scholar]
  5. Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. N Engl J Med 2004;351:1645–1654 [CrossRef][PubMed]
    [Google Scholar]
  6. Public Health England Investigation of Orthopaedic Implant Associated Infections, UK Standards for Microbiology Investigations, B 44, Issue 2. London: Public Health England; 2016
    [Google Scholar]
  7. Saeed MU, Mariani P, Martin C, Smego RA, Potti A et al. Anaerobic spondylodiscitis: case series and systematic review. South Med J 2005;98:144–148 [CrossRef][PubMed]
    [Google Scholar]
  8. Uemura H, Hayakawa K, Hamada Y, Yamamoto K, Kutsuna S et al. P324: Parvimonas micra as a causative organism of spondylodiscitis: a report of 3 cases. Int J Antimicrob Agents 2013;42:S144 [CrossRef]
    [Google Scholar]
  9. Brook I. Two cases of diskitis attributable to anaerobic bacteria in children. Pediatrics 2001;107:e26 [CrossRef][PubMed]
    [Google Scholar]
  10. Le Moal G, Juhel L, Grollier G, Godet C, Azais I et al. Vertebral osteomyelitis due to Fusobacterium species: report of three cases and review of the literature. J Infect 2005;51:E5E9 [CrossRef][PubMed]
    [Google Scholar]
  11. Fihman V, Hannouche D, Bousson V, Bardin T, Lioté F et al. Improved diagnosis specificity in bone and joint infections using molecular techniques. J Infect 2007;55:510–517 [CrossRef][PubMed]
    [Google Scholar]
  12. Joosten A, Verhaegen J, van Wijngaerden E. Fusobacterium nucleatum spondylodiscitis: case report and literature review. Clin Microbiol Newsl 2011;33:115–117 [CrossRef]
    [Google Scholar]
  13. Ramos A, Berbari E, Huddleston P. Diagnosis and treatment of Fusobacterium nucleatum discitis and vertebral osteomyelitis. Spine 2013;38:E120E122 [CrossRef]
    [Google Scholar]
  14. Griffin AT, Christensen D. Fusobacterium spondylodiscitis: case report and literature review. Diagn Microbiol Infect Dis 2014;78:491–493 [CrossRef][PubMed]
    [Google Scholar]
  15. Papasian CJ, Mcgregor DH, Hodges GR, Kennedy J. Peptostreptococcal vertebral osteomyelitis. J Clin Microbiol 1986;24:633–635[PubMed]
    [Google Scholar]
  16. Leder KS, Barlam TF. A case of paraspinal abscess and diskitis due to Peptostreptococcus micros. Clin Infect Dis 2000;30:622–623 [CrossRef][PubMed]
    [Google Scholar]
  17. García González M, Muñiz Montes JR, García Rosado D, Bustabad Reyes S. Multifocal hematogenous vertebral osteomyelitis due to Parvimonas micra and a subsequent pleural effusion in a diabetic patient. Reumatol Clin 2014;10:191–192 [CrossRef][PubMed]
    [Google Scholar]
  18. Jones SL, Riordan JW, Glasgow AL, Botes J, Boutlis CS. Two cases of spondylodiscitis caused by Parvimonas micra. Intern Med J 2015;45:1090–1091 [CrossRef][PubMed]
    [Google Scholar]
  19. Gahier M, Cozic C, Bourdon S, Guimard T, Cormier G. Spinal infections caused by Parvimonas micra. Med Mal Infect 2015;45:397–398 [CrossRef][PubMed]
    [Google Scholar]
  20. Endo S, Nemoto T, Yano H, Kakuta R, Kanamori H et al. First confirmed case of spondylodiscitis with epidural abscess caused by Parvimonas micra. J Infect Chemother 2015;21:828–830 [CrossRef][PubMed]
    [Google Scholar]
  21. Pilmis B, Israel J, Le Monnier A, Mizrahi A. Spondylodiscitis due to anaerobic bacteria about a case of Parvimonas micra infection. Anaerobe 2015;34:156–157 [CrossRef][PubMed]
    [Google Scholar]
  22. Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother 2010;65:iii11–iii24 [CrossRef][PubMed]
    [Google Scholar]
  23. Patzakis MJ, Rao S, Wilkins J, Moore TM, Harvey PJ. Analysis of 61 cases of vertebral osteomyelitis. Clin Orthop Relat Res 1991;264:178–183 [CrossRef]
    [Google Scholar]
  24. Hadjipavlou AG, Mader JT, Necessary JT, Muffoletto AJ. Hematogenous pyogenic spinal infections and their surgical management. Spine 2000;25:1668–1679 [CrossRef][PubMed]
    [Google Scholar]
  25. Murdoch DA. Gram-positive anaerobic cocci. Clin Microbiol Rev 1998;11:81–120[PubMed]
    [Google Scholar]
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