Atypical presentation of thoracic spondylodiscitis caused byStreptococcus mitis

Abstract

SUMMARYSpondylodiscitis, which is most commonly caused by Staphylococcus aureus, is an uncommon infection in adults. The diagnosis of spondylodiscitis is often delayed by its vague and non-specific presentations. As part of the normal flora in human mouth and sinuses, Streptococcus mitis is a very rare cause of spondylodiscitis. We report a case of thoracic spondylodiscitis caused by S. mitis in a patient with chronic sinusitis. The patient atypically presented with a sharp chest pain that radiated to the back and the imaging studies were initially negative. He failed outpatient pain management and the diagnosis of spondylodiscitis was confirmed by bone biopsy 6 weeks later. Treatment with antibiotics completely alleviated the pain. Increased awareness and a high index of suspicion are essential for early diagnosis of spondylodiscitis with an atypical presentation. BACKGROUND

Association between oral microbiome and five types of respiratory infections: a two-sample Mendelian randomization study in east Asian population

“…Furthermore, Mehra underscores the significant role of odontogenic factors in chronic sinusitis, suggesting that dental conditions like periodontitis may impact sinus health via alterations in the oral microbiome's composition (Mehra and Jeong, 2009). The detection of Streptococcus mitis in chronic sinusitis patients' sinuses corroborates its contributory role in the condition's inflammation and pathogenesis as an oral microbiota component (Paju et al, 2003;Cariati and Deng, 2014). Likewise, the enrichment of Rothia mucilaginosa in these patients' sinus microbiota indicates its potential involvement in the disease's pathology, aligning with our research findings (Yuan et al, 2020).…”

Vacuum-assisted closure for chest wall reconstruction infection caused by Streptococcus mitis after surgery of lung cancer: a case report

“…Streptococcus mitis (S. mitis) has been individually identified as a part of the normal oropharyngeal flora, and has been mostly reported in cases of bacterial endocarditis and lung abscess through the bloodstream or respiratory tract [16][17][18][19]. On the other hand, there are a few rare cases of urinary tract infection, spondylodiscitis, and empyema caused by S. mitis [20][21][22]. Although the cause of infection around PTFE sheet in the present case was unclear because of no odontogenic infection and negative of the blood culture was negative, it is considered an extremely rare case.…”

Epidural abscess related toStreptococcus mitisin a 57-year-old immunocompetent patient

“…10 12 Cariati et al described a thoracic spondylodiscitis in a patient with chronic sinusitis. 13 Feder and Gruson reported a case of glenohumeral infection, 14 Nomura et al reported an osteomyelitis of a lower extremity bone in a child. 15 Yusuf and colleagues 16 and Cinar et al 17 published cases of pelvic ring infections.…”