Espondilodiscitis y sacroileítis por Streptococcus agalactiae en adultos: caso clínico y revisión de la literatura

Díaz-Gonzálvez, Eduardo; Zarza, Beatriz Eizaguirre; Abreu, Paloma de; Cobo, Javier; Orte, Javier; Dronda, Fernando

doi:10.1157/13071609

Cited by 10 publications

(4 citation statements)

References 32 publications

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“…SA als verwekker van spondylodiscitis is uitzonderlijk. In de literatuur zijn er tot op heden slechts een dertigtal gevallen gemeld (1)(2)(3)(4)(5)(6)(7)(8).…”

Section: Inleidingunclassified

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Cervicale spondylodiscitis veroorzaakt door Streptococcus agalactiae

WEYNANTS L,

RIMBAUT S

2015

Tijdschrift Voor Geneeskunde

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Bij een voordien volstrekt gezonde patiënt van 45 jaar werd cervicale spondylodiscitis op niveau C5-C6 gediagnosticeerd. Hij kwam naar de raadpleging wegens hevige pijn cervicaal, uitstralend naar de schouders sinds enkele dagen. Hij was koortsvrij. Een discuspunctie op niveau C5-C6 gaf Streptococcus agalactiae (SA) als verwekker, wat zeer uitzonderlijk is voor deze aandoening. Een intraveneuze behandeling met achttien miljoen eenheden penicilline per dag en driemaal 600 mg clindamycine gedurende vier weken had snel resultaat. De perorale antibiotherapie werd nog zes weken verdergezet.SA is vooral bekend als verwekker van infecties bij pasgeborenen en zwangere vrouwen. De laatste jaren worden echter steeds vaker infecties met SA aangetroffen bij niet-zwangere volwassenen. Vaak, maar niet altijd zijn er onderliggende aandoeningen aanwezig, zoals diabetes mellitus, maligniteiten, nierinsufficiëntie, levercirrose en corticoïdgebruik. Een andere mogelijke verklaring voor deze stijging kan een toename van de virulentie van SA zijn.

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“…SA als verwekker van spondylodiscitis is uitzonderlijk. In de literatuur zijn er tot op heden slechts een dertigtal gevallen gemeld (1)(2)(3)(4)(5)(6)(7)(8).…”

Section: Inleidingunclassified

“…Spondylodiscitis veroorzaakt door SA is echter zeer zeldzaam. De afgelopen vijfentwintig jaar zijn er slechts een dertigtal gevallen beschreven in de literatuur (1)(2)(3)(4)(5)(6)(7)(8).…”

Section: Besluitunclassified

Cervicale spondylodiscitis veroorzaakt door Streptococcus agalactiae

WEYNANTS L,

RIMBAUT S

2015

Tijdschrift Voor Geneeskunde

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“…6 GBS causing spondylodiscitis is uncommon but has been described in the past, primarily in elderly or immune-compromised patients, although cases have been reported in patients without underlying disease. [8][9][10][11] Clinical diagnosis of spondylodiscitis is difficult. The main presenting complaint is insidious onset of back pain, which is constant and typically worse at night.…”

Section: Group B Streptococcal Infection -An Emerging Cause Of Sepsismentioning

confidence: 99%

Group B Streptococcal Infection — An Emerging Cause of Sepsis in Fit Non-Peripartum Adults

Gunasekera

Asumang

2014

Journal of the Intensive Care Society

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A previously fit 66-year-old presented to hospital with a history of back pain, decreased level of consciousness and one grand mal seizure. She was ultimately found to have group B streptococcal infection with Streptococcus agalactiae thought to be secondary to spondylodiscitis, possibly secondary to latent infection from an abdominal hysterectomy performed 30 years previously. This case highlights the increasing incidence of group B streptococcal infection in nonperipartum adults, and the implications are discussed.

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“…It is caused when an infection in another part of the body spreads through the blood stream to the spine 9 . It usually affects healthy individuals 10 as well as those with predisposing conditions such as advanced age, 8 diabetes mellitus, 8,11 immunocompromised patients, 12,13 preceding or concomitant infections, 14,15 severe multisystem trauma 16 and intravenous drug addicts 17…”

Section: Introductionmentioning

confidence: 99%

Infectious discitis in adults: 9 years experience from Al‐Yarmouk Teaching Hospital in Baghdad, Iraq

Sakeni¹,

Al-Nimer

2008

Int J of Rheum Dis

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Aim: The objective of this study was to analyse the presentation, aetiology, diagnosis, management, and outcome of infectious discitis. Methods: A screening prospective case‐finding study was carried out at Al‐Yarmouk teaching hospital in Baghdad, Iraq from 1997 to 2006. Fifty adult patients (12 men and 38 women) were diagnosed with infectious discitis from different referral sources. The diagnosis was based on laboratory biochemical tests, isolation of micro‐organisms from blood and needle aspiration tissue, and radiological investigations including magnetic resonance images (MRI). Results: Of the 50 cases, 32 (64%) patients presenting within 4 weeks, 94% had pelvic and abdominal surgical interventions, 70% presented with severe neck pain and 36% had neurological deficits. Marked elevation of erythrocyte sedimentation rate and high serum C‐reactive protein levels were observed in all patients. Positive blood, percutaneous disc aspiration and surgical exploration samples for Staphylococcus aureus, Streptococcus viridans, E. coli, Pseudomonas aureginosa and Candida albicans were found. Radiological images showed that disc involvement did not exceed more than one intervertebrate disc with two adjacent vertebrae. The clinical outcome was full recovery (86%), residual neurological deficits (10%) and death (4%). Conclusions: Infectious discitis in adults should be suspected in every case presenting with severe neck or back pain, followed by pelvic or abdominal surgical interventions. Therefore, MRI techniques should be performed on every case and an early empirical antibiotic therapy is advised.

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Espondilodiscitis y sacroileítis por Streptococcus agalactiae en adultos: caso clínico y revisión de la literatura

Cited by 10 publications

References 32 publications

Cervicale spondylodiscitis veroorzaakt door Streptococcus agalactiae

Cervicale spondylodiscitis veroorzaakt door Streptococcus agalactiae

Group B Streptococcal Infection — An Emerging Cause of Sepsis in Fit Non-Peripartum Adults

Infectious discitis in adults: 9 years experience from Al‐Yarmouk Teaching Hospital in Baghdad, Iraq

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