Pyogenic Vertebral Osteomyelitis after Acute Bacterial Prostatitis: A Case Report

Abstract

A case of pyogenic vertebral osteomyelitis after acute bacterial prostatitis in a 78-year-old man is reported. The rarity and subtle clinical presentation of this condition, and the delayed appearance of radiologic signs of progression to destructive osteomyelitis, contributed to a significant delay in diagnosis. An arterial blood culture positive for bacterial growth during the episode of acute prostatitis suggested that bacteremia might result from hematogenous spread of the infection to the vertebral column via the venous system. Since intensive antimicrobial therapy proved ineffective, debridement of the first and second lumbar vertebral bodies, and anterior spinal fusion from the twelfth thoracic to the third lumbar vertebrae were performed. The patient's high fever and severe lumbago subsided immediately after the surgery. The possibility of development to pyogenic vertebral osteomyelitis should be kept in mind when treating a serious genitourinary tract infection.Int J Urol 1996;3:402-404

Spondylodiscitis as a Spinal Complication of Transrectal Ultrasound-Guided Needle Biopsy of the Prostate

“…10 Although pyogenic spondylodiscitis in this case did not originate from primary prostate infection, it occurred after an iatrogenic inoculation of the bacteria into the prostate gland by a needle passing through the highly contaminated rectum. Demonstration of E. coli in culture and Gram ( − ) bacilli in granulation tissue supports the fecal route.…”

Acute and Chronic Prostatitis Syndromes: A Review of Microbiologic and Pathologic Issues

“…Vigorous massage in this setting is contraindicated due to the risk of bacteremia. For example, there is evidence of bacteremia‐related sequelae such as vertebral osteomyelitis after prostatitis ( 5). Chronic bacterial prostatitis typically presents in older men with a history of acute prostatitis or other urinary tract infections ( 5).…”

“…For example, there is evidence of bacteremia‐related sequelae such as vertebral osteomyelitis after prostatitis ( 5). Chronic bacterial prostatitis typically presents in older men with a history of acute prostatitis or other urinary tract infections ( 5). Patients typically complain of frequent urination and pain (perineal, suprapubic, testicular, and urethral).…”

Vertebral infection

“…Описано возникновение остеоми-елита позвоночника после септичес-ких абортов [27,174], урологических операций [63, 145,164,165,178], пос-ле аортографии, операций на прямой кишке [135], при инфекциях в полос-ти рта.…”

“…Источниками инфекции в позво-ночник являются тромбофлебит ниж-них конечностей, хронические язвы голени, воспаление легких, хроничес-кий тонзиллит, кариес зубов, мастит, панкреатит, простатит, урологические заболевания [43,82,128,166,178].…”