Vertebral osteomyelitis and epidural abscess due to <i>Listeria monocytogenes</i> – case report and review of literature

Abstract

Abstract. We describe a case of native vertebral osteomyelitis (NVO) secondary to Listeria monocytogenes in a patient with polymyalgia rheumatica receiving chronic steroids. Treatment required surgical debridement of the epidural phlegmon and combination therapy with intravenous ampicillin and gentamicin.

Clinical Findings of Listeria monocytogenes Infections with a Special Focus on Bone Localizations

“…Vertebral osteomyelitis represents an even less frequent localization of invasive listeriosis. To date, eight cases [ 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 ] have been reported in the literature and most of them had significant risk factors for developing invasive listeriosis ( Table 2 ). Figure 1 showed the MRI evolution of a patient with epidural abscess by L. monocytogenes from diagnosis to complete recovery after both surgical and antibiotic treatment [ 101 ].…”

“…Reports of L. monocytogenes bone infections are usually described in patients with predisposing factors, such as diabetes, leukemia, or receipt of long-term corticosteroids or immune-modulant treatments [88][89][90][91][92]. Usually, native vertebral L. monocytogenes infections have an insidious course, with symptoms, especially back pain, that could be present for over a year, as described in previous reports [93,94]. In the review by Charlier et al, more than 70% of cases of listeriosis involving bone and joint infections were subacute or chronic at the onset.…”

Clinical Findings of<em> Listeria monocytogenes</em> Infections with a Special Focus on Bone Localizations

“…Reports of bone infections by L. monocytogenes are usually described in patients with predisposing factors as diabetes, leukemia or receiving long-term corticosteroids or immunemodulant treatments [85][86][87][88][89]. Usually, native vertebral infections by L. monocytogenes have an insidious course, with symptoms, especially back pain, that could be present for over a year, as described in previous reports [90,91]. In the review by Charlier et al more than 70% of cases of listeriosis involving bone and joint infections were subacute or chronic at the onset.…”

“…Vertebral osteomyelitis represents an even less frequent localization of invasive listeriosis. To date, eight other cases [90][91][92][93][94][95][96][97] have been reported in literature and all of them had significant risk factors for developing invasive listeriosis. All these patients were treated with ampicillin or amoxicillin or benzyl penicillin; 5 patients received combination with aminoglycosides; treatment duration was highly heterogeneous among these reports, ranging from 6 to 28 weeks, accordingly to possible delayed clinical responses.…”