Listeria spondylodiscitis: an uncommon etiology of a common condition; a case report

Abstract

Background Listeriosis is a severe food-borne infection caused by the Gram-positive rod, Listeria monocytogenes. Despite the low incidence (3–8 cases per million), Listeriosis has a case fatality rate of 20–30% as it occurs predominantly in immunocompromised individuals at extremes of age, diabetics and pregnant women. Listeriosis classically presents as a febrile gastroenteritis, isolated bacteremia, meningitis, or maternal-fetal infections. Focal bone and joint infection are rare and primarily involve orthopedic implant devices. Here, we present the first case of Listeria-associated spondylodiscitis. Case presentation A 79-year-old male presents with acute-on-chronic back pain in the absence of risk factors or exposures, aside from age. On radiological imaging, spondylodiscitis of L3-L4 was diagnosed. Subsequently, a CT-guided biopsy was performed to aid in confirming microbiological aetiology. Listeria monocytogenes was grown in culture and patient received appropriate antibacterial therapy. Conclusion The case highlights the utility of image-guided tissue sampling in aiding diagnosis and management in patients with vertebral osteomyelitis. It also encourages consideration of uncommon organisms such as Listeria as an etiology of vertebral osteomyelitis, even in the absence of prosthetic implants.

Successful Treatment of Spondylodiscitis and Infectious Sacroiliitis due to Listeria monocytogenes using Meropenem as Salvage Therapy

“…[11] , joint involvement often occurs in middle-aged patients and usually affects the large joints such as the hip or knee due to haematogenous spread. Spondylodiscitis due to L. monocytogenes has recently been reported [7,12] but seems to be rare, and to our knowledge, this is the first description of septic sacroiliitis due to listeria. Regarding medical imaging, MRI is the gold standard to diagnose spondylodiscitis or sacroiliitis, owing to its good sensitivity and specificity [3] .…”

“…Pyogenic sacroiliitis is very rare, accounting for less than 2% of infectious arthritis cases. Osteoarticular infection due to L. monocytogenes is unusual with very few cases reported [7,[10][11][12] . According to Schett et al .…”

“…Involvement of soft tissues and the epidural space are best evaluated after contrast injection [12] . In our case, concomitant bacteraemia allowed identification of the causal agent without invasive sampling.…”

Listeria endocarditis and spondylodiscitis: a case report and review of the literature

“…Spinal involvement is less common, resulting in spondylodiscitis. To our knowledge, 7 cases of Listeria spondylodiscitis have been described in the literature (Table 1) [4,9,10,11,12,13,14]. In some cases, the diagnosis was confirmed by spinal biopsy.…”

Listeria endocarditis and spondylodiscitis: A case report and review of the literature

“…To our knowledge, 7 cases of Listeria spondylodiscitis have been described in the literature (Table 1). 4,[9][10][11][12][13][14] In some cases, the diagnosis was confirmed by spinal biopsy. The association between LM spondylodiscitis and endocarditis is reported in one case.…”