Pyogenic Spondylodiscitis due to Streptococcus constellatus in an Immunocompromised Male Patient: A Case Report and Review of the Literature

Abstract

Pyogenic spondylodiscitis is a primary infection of the intervertebral disc and is a rare entity. Here, we describe the case of a 64-year-old male patient, a professional breeder, who attended the Emergency Department with sciatica and back pain that was worsening for a week. The patient had no history of surgery or trauma. The patient had poor oral hygiene. Magnetic resonance imaging (MRI) scan showed lumbar spondylodiscitis, and blood cultures revealed Streptococcus constellatus. The patient was initially treated with vancomycin but due to renal failure deterioration, the treatment was changed to daptomycin www.videleaf.com for 8 weeks. During hospitalization, he endured renal injury and nosocomial respiratory tract infection. The patient was discharged with no further complications. Follow-up revealed improvement of neurological signs. In our case, it seems that poor oral hygiene was the cause of bacteremia, which underlies the importance of a good oral health status in immunocompromised patients not only to prevent but also to successfully eliminate any dental source of infection. S. constellatus is an extremely rare pathogen and to our knowledge only two other cases of pyogenic spondylodiscitis are reported in the literature. Early diagnosis is very important for the prognosis of these patients.

Bone kaposiform hemangioendothelioma: A rare entity dramatically improved by sirolimus

“…It can in rare cases be responsible for bone and joint infections in adults with poor oral hygiene, but it is not commonly responsible for bone and joint infections in children, in whom sample contamination should be suspected. 5,6 The absence of any abnormal feature on histological analysis was discordant with the importance of clinical and imaging signs. Finally, the poor response to treatment for an infectious osteomyelitis must call into question the initial diagnosis and lead to repeating the explorations.…”

“…This bacterium is part of normal flora of the oral cavity, gastrointestinal, and urogenital system. It can in rare cases be responsible for bone and joint infections in adults with poor oral hygiene, but it is not commonly responsible for bone and joint infections in children, in whom sample contamination should be suspected 5,6 . The absence of any abnormal feature on histological analysis was discordant with the importance of clinical and imaging signs.…”

Pyogenic thigh abscess caused by Streptococcus constellatus subsp. constellatus in a patient with exacerbation of bronchiectasis: a case report

“…Although infections caused by S. constellatus can be observed in individuals with normal immunity, a growing list of conditions were identified as potential predisposing factors, such as alcohol abuse, trauma, surgery, immunosuppression, multimorbidity, rheumatic diseases, cardiovascular diseases, chronic obstructive pulmonary disease, concurrent infection, and diabetes mellitus (3,18). Our patient had chronic underlying bronchiectasis and was suffering an acute exacerbation, so further work should examine whether this condition also is a predisposing factor of S. constellatus infection.…”

“…viborgensis (2). S. constellatus used to be considered opportunistic pathogen and could cause infections in patients with chronic respiratory diseases, cardiovascular diseases, or immunocompromised and immunodeficient diseases (3). Recent studies, however, have detected S. constellatus in individuals with normal immunity, often together with certain anaerobic strains, which exacerbate © Annals of Palliative Medicine.…”