A case of polymicrobial anaerobic spondylodiscitis due to Parvimonas micra and Fusobacterium nucleatum

Abstract

Introduction. Here, we present a case of polymicrobial anaerobic spondylodiscitis. Case Presentation. 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 Parvimonas micra and Fusobacterium nucleatum, 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. Conclusion. Anaerobic discitis is rare, and polymicrobial discitis is rarer still. A PubMed literature review revealed only seven cases of F. nucleatum discitis and only twelve cases of P. micra 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.

Osteomyelitis of the Distal Phalanx of the Thumb due to Parvimonas micra and Fusobacterium nucleatum: A Case Report

“…There are few reports on pyogenic spondylitis [ 3 ] and septic arthritis of the knee [ 4 ]; however, there are no reports on P. micra causing osteomyelitis in the fingers. On the other hand, there are several reports on the occurrence of osteomyelitis in the spine [ 5 ] and long bones [ 6 ]; however, there are no reports on the occurrence of finger osteomyelitis due to F. nucleatum . This is the first report on osteomyelitis of the finger bone caused by P. micra and F. nucleatum, which is probably related to the treatment of dental caries.…”

Parvimonas Micra and Fusobacterium Nucleatum Septic Arthritis: A Rare Anaerobic Double Trouble

“…Aerobic culture remained negative while anaerobic culture yielded P. micra and F. nucleatum. Polymicrobial anaerobic infection with P. micra and F. nucleatum is a rare finding in bone and joint infections, except for a case of spondylodiscitis reported by Cleaver et al [13]. Elevated counts of white blood cells in synovial fluid have little significance in the diagnosis of septic arthritis; however, in the present case, the procedure could not be performed in the presence of necrotic cells.…”

An iliopsoas abscess caused by Parvimonas micra: a case report

“…Cobo et al reported that P. micra infections were diagnosed on the basis of infected fluids in 38.7% of cases, blood cultures in 29%, and molecular techniques in 22.5% [5]. In recent times, as new methods (e.g., 16S ribosomal RNA sequencing [3], matrix-assisted laser desorption ionization time-of-flight mass spectrometry [4], and melting temperature mapping [16]) have become more available in routine diagnostic laboratories, P. micra has been increasingly detected in various invasive human infections.…”