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

Koruga, Nenad; Rončević, Alen; Koruga, Anamarija Soldo; Sabadi, Dario; Drenjančević, Domagoj; Prica, Ana; Rotim, Tatjana; Turk, Tajana; Kretić, Domagoj

doi:10.3390/diagnostics12112686

Cited by 3 publications

(2 citation statements)

References 16 publications

(28 reference statements)

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Zhang¹,

Lai²,

Li³

et al. 2023

IDR

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The incidence of a spinal epidural abscess (SEA), which can cause serious neurological complications, is low; however, the incidence of SEA caused by Streptococcus is even lower, most of which are reported in the thoracolumbar spine and lumbosacral segment. We reported a case of cervical SEA caused by Streptococcus constellatus infection, resulting in paralysis of the patient. The acute onset of SEA in a 44-year-old male led to decreased upper limb muscle strength, lower limb paralysis, and loss of bowel and bladder function, and imaging and blood tests suggested pyogenic spondylitis. Emergency decompression surgery and antibiotic therapy were given, the patient gradually recovered, and the muscle strength of the lower limbs gradually improved. This case report suggests the importance of early decompressive surgery and effective antibiotic therapy.

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Section: Discussionmentioning

confidence: 99%

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

Zhang¹,

Lai²,

Li³

et al. 2023

IDR

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“…Streptococcus constellatus (SC) is a part of Streptococcus anginosus group and is usually colonized in the normal mouth, gut, and urogenital tract flora. [ 1 ] However, in some specific cases, it has the potential to spread to physiologically sterile anatomical sites and cause infections. According to its anatomical distribution, SC can cause suppurative infections at multiple anatomical sites, mostly in patients who are immunosuppressed or undergoing invasive procedures.…”

Section: Introductionmentioning

confidence: 99%

A rare case of aggressive pyogenic spondylitis with giant abscesses after vertebral augmentation

Liu,

He,

Long

et al. 2023

Jt Dis Relat Surg

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Although Streptococcus constellatus (SC), an opportunistic pathogen, can cause abscesses and empyema. The SC infection after vertebral augmentation (VA) can interfere with patients' daily living activities and can be life-threatening in severe cases. A 67-year-old male complained of lumbar pain for two months. The patient underwent percutaneous vertebroplasty of the second and third lumbar vertebrae two months ago. On admission, laboratory and imaging evidence suggested infection of the second and third lumbar vertebrae with bilateral psoas major and left lumbodorsal abscesses. After three weeks of empirical anti-infective therapy, abscess removal and the second and third lumbar vertebrae fusion with iliac bone graft were performed under general anesthesia. Intraoperative pathology and next-generation sequencing (NGS) examination of the pus suggested SC infection, and oral linezolid was given for 12 weeks after surgery. The infection was eventually cured and the patient achieved satisfactory function. In conclusion, pyogenic spondylitis due to SC infection after VA is a life-threatening complication. In addition to infectious disease consultation and routine etiological screening, NGS is important to identify infection with unknown pathogens. Surgery combined with sensitive antibiotics is appropriate for patients with progressive neurological deficits.

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Streptococcus anginosus spondylodiscitis causing incapacitating back pain in an immunocompetent patient: A case report

Torres-Nolasco,

Arquinio Estremadoyro,

Valenzuela-Rodríguez

2024

SAGE Open Medical Case Reports

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Pyogenic spondylodiscitis is uncommon and usually presents in the setting of immunosuppression. Streptococcus anginosus group are opportunistic pathogens that rarely cause this infection. We present a case of an immunocompetent 45-year-old male with extreme lower back pain, not even relieved by opioids. A magnetic resonance imaging done the day before arrival showed multiple lumbar disk degeneration and lumbar spondylosis. Initial examinations did not show significant alteration. During inpatient admission, his values of erythrocyte sedimentation rate and C-reactive protein increased, and a new magnetic resonance imaging with contrast revealed signs of spondylodiscitis at the L2–L3 level. He underwent open surgery for tissue sampling and stabilization of the affected segment. Blood culture, disk sampling culture, and myeloculture were positive for S. anginosus. Additional examinations were negative for immunosuppression or any underlying condition, and the dental evaluation only showed mild gingivitis. The patient received intravenous antibiotics, and the pain significantly improved after surgery. He was finally discharged and completed 8 weeks of antibiotics. The erythrocyte sedimentation rate and C-reactive protein values were normal 6 weeks after surgery, and on a 1-year follow-up, the magnetic resonance imaging showed stable post-surgical changes with no signs of infection.

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

Cited by 3 publications

References 16 publications

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

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

A rare case of aggressive pyogenic spondylitis with giant abscesses after vertebral augmentation

Streptococcus anginosus spondylodiscitis causing incapacitating back pain in an immunocompetent patient: A case report

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