Cervical osteomyelitis caused by Burkholderia cepacia after rhinoplasty

Objectives The Burkholderia cepacia complex (Bcc), which was originally thought to be a single species, represents a group of 24 distinct species that are often resistant to multiple antibiotics, and usually known to cause life-threatening pulmonary infections in cystic fibrosis patients. Herein we describe a series of non-respiratory Bcc infections, the risk factors and epidemiologic factors, in addition to the clinical course. Patients and methods This is a retrospective chart review of 44 patients with documented B. cepacia infections isolated from sites other than the respiratory tract admitted between June 2005 and February 2020 to the American University of Beirut Medical Center (AUBMC), a tertiary referral hospital for Lebanon and the Middle East region. The epidemiological background of these patients, their underlying risk factors, the used antibiotic regimens, and the sensitivities of the B. cepacia specimens were collected. Results The majority of the Bcc infections (26/44, 59.1%) were hospital-acquired infections. The most common nationality of the patients was Iraqi (18/44, 40.9%), and the most common site of infection was bacteremia (17/44, 38.6%), followed by skin and soft tissues infections (16/44, 36.4%) and vertebral osteomyelitis (8/44, 18.2%). Most of the isolated B. cepacia were susceptible to ceftazidime, carbapenems, followed by TMP-SMX. Patients responded well to therapy with good overall outcome. Conclusions Bcc can cause infections outside the respiratory tract, mostly as hospital-acquired infections and in immunocompromised patients. Most patients were referred from countries inflicted by wars raising the possibility of a potential role of conflicts which need to be investigated in future studies. Directed therapy according to susceptibility results proved effective in most patients.

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Burkholderia cepacia Infections at Sites Other than the Respiratory Tract: A Large Case Series from a Tertiary Referral Hospital in Lebanon

Kwayess

Hariri

Hindy

et al. 2022

J Epidemiol Glob Health

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Lumbar Spondylodiscitis Caused byBurkholderia cepaciain a Previously Healthy Patient

Jaafar

Rizkallah

Atallah

et al. 2017

Case Reports in Orthopedics

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Burkholderia cepacia complexCervical Osteomyelitis in an Intravenous Drug User

Messer

2018

Case Reports in Infectious Diseases

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Gram-negative vertebral osteomyelitis infections are increasing due to rising intravenous drug use but overall remain uncommon. Here, we present a case of Burkholderia cepacia complex cervical osteomyelitis in an intravenous drug user. Burkholderia cepaciacomplex vertebral osteomyelitis has been infrequently described in the literature thus far with varied antibiotic treatment regimens. A 68-year-old male presented to the emergency department with neck pain after minor trauma. He endorsed active intravenous heroin and methamphetamine use. CT and MRI imaging of the cervical spine revealed destructive changes of C5-C6 vertebral bodies consistent with osteomyelitis. Neurological exam was stable and vital signs were within normal limits; so, antibiotics were held, and he was admitted for diagnostic evaluation. Five sets of blood cultures were drawn on admission and were ultimately negative. He subsequently underwent C5-C6 corpectomy, C4-C7 anterior fusion, and C3-T1 posterior fusion with allograft placement. Deep operative tissue cultures grew Burkholderia cepacia complex. He was treated with 6 weeks of intravenous ceftazidime followed by indefinite oral minocycline due to hardware placement. Burkholderia cepacia complex should be considered among pathogenic etiologies of pyogenic vertebral osteomyelitis, particularly among patients with intravenous drug use. Ceftazidime monotherapy was an effective treatment in this particular case.

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Cervical osteomyelitis caused by Burkholderia cepacia after rhinoplasty

Abstract: Burkholderia cepacia, previously known as Pseudomonas cepacia, has been implicated in vertebral osteomyelitis in patients who are intravenous drug abusers. We report a case of acute vertebral osteomyelitis in a non-intravenous drug user, following an elective rhinoplasty.

Cited by 8 publications

References 7 publications

Burkholderia cepacia Infections at Sites Other than the Respiratory Tract: A Large Case Series from a Tertiary Referral Hospital in Lebanon

Burkholderia cepacia Infections at Sites Other than the Respiratory Tract: A Large Case Series from a Tertiary Referral Hospital in Lebanon

Lumbar Spondylodiscitis Caused byBurkholderia cepaciain a Previously Healthy Patient

Burkholderia cepacia complexCervical Osteomyelitis in an Intravenous Drug User

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