Acute Pyogenic Spondylitis Caused by Streptococcus Constellatus in an Obese Patient: A Case Report

Abstract

Streptococcus constellatus ( S. constellatus ) is a well-known part of the normal flora in humans. Pyogenic spondylitis (PS) induced by S. constellatus is very rare. In this case, a 46-year-old male patient presented to our hospital with a 2-month history of low back pain and weakness in both legs. Based on his clinical manifestations, laboratory findings, blood culture results, imaging and histopathological findings, the patient was diagnosed with PS caused by S. constellatus . One unique aspect of this case is the acute and severe course of infection, which resulted in multiple organ dysfunction syndrome and septic shock in the first week and rapid vertebral destruction within 2 months of the patient’s admission. His obese status may be relevant to his presentation. This case report suggests that S. constellatus infections should not be overlooked, especially in patients with known risk factors and predispositions to infectious diseases.

Acute Spinal Epidural Abscess of the Cervical Spine Caused by Streptococcus constellatus Leads to Paraplegia in an Adult: A Case Report

“…Streptococcus constellatus is an extremely rare SEA pathogen with only a few cases. For instance, Dai et al reported that a 58-year-old female had SEA caused by Streptococcus constellatus infection, 7 Korugan et al reported invasive suppurative spondylitis caused by Streptococcus constellatus infection, 8 Jin et al reported another obese patient with acute suppurative spondylitis caused by Streptococcus constellatus , 3 and Takada et al reported a rare case of suppurative thrombophlebitis of the posterior neck caused by Streptococcus constellatus . 9 All of these patients recovered after surgery and 6–8 weeks of systemic antibiotics.…”

“…9 All of these patients recovered after surgery and 6-8 weeks of systemic antibiotics. 3 The diagnosis of SEA needs to be made carefully, and a correct diagnosis is crucial to the treatment of SEA. As we reported in this case, his clinical symptoms (high fever, limb paraplegia, motor sensory dysfunction, urination and defecation dysfunction) were not specific, and there are similar manifestations in other diseases, such as cervical spondylotic myelopathy.…”

“… 1 The incidence of SEA caused by Streptococcus is even lower, and SEA is an uncommon problem that accounts for 0.2 to 2 per 10,000 hospital admissions. 2 Staphylococcus aureus is the most common pathogen of SEA, 3 whereas SEA induced by Streptococcus constellatus , which is found in normal human flora, is very rare and has only been reported to be localized in the thoracic region, closely followed by lumbar involvement. We reported an extremely rare case of cervical spine SEA caused by Streptococcus constellatus infection causing paralysis in a patient.…”

Aggressive Pyogenic Spondylitis Caused by S. constellatus: A Case Report

“…To the best of our knowledge, and based on the review of the published literature, similar cases of pyogenic paracostal and paravertebral abscesses were not yet described. There are only a handful of case reports reporting pyogenic spondylitis caused by SC [ 10 , 11 , 12 , 13 , 14 ]. The case that was similar the most in the published literature was by Jin and Yin in which they presented a patient diagnosed with pyogenic spondylitis caused by SC [ 10 ].…”

“…There are only a handful of case reports reporting pyogenic spondylitis caused by SC [ 10 , 11 , 12 , 13 , 14 ]. The case that was similar the most in the published literature was by Jin and Yin in which they presented a patient diagnosed with pyogenic spondylitis caused by SC [ 10 ]. That patient was of similar age as the patient in our case report; however, he was male and obese, with a body mass index (BMI) of over 40 kg/m 2 .…”