Skipped vertebral spontaneous spondylodiscitis caused by Granulicatella adiacens: Case report and a systematic literature review

Abstract

Background: Granulicatella adiacens is a nutritional variant of streptococcus (NVS), which has been rarely reported as an etiologic agent in spondylodiscitis (SD). Material and methods: We report a case of a 51-year-old male with from chronic low-back pain associated with right sciatica and ipsilateral monoparesis. Spinal MRI showed radiological signs on L1-L2 and L5-S1 discs consistent with SD. We also performed a systematic review of the pertinent literature in order to retrieve all the key information regarding microbiological and clinical features. Results: Including our patients, seven cases with a mean age 56 ± 10.2 years were reported in English literature. Six patients were conservatively managed with antibiotic therapy (66%), whereas three with surgery in combination with antibiotics (33%). An endocarditis was associated in three cases, and a pacemaker infection in one. All patients received targeted antibiotic therapy resulting in a quick improvement of clinical symptoms with favorable outcome. Our case is the only with a skip spontaneous SD, which needed a surgical decompression due to the associated neurological symptoms. Conclusions: This incidence of SD sustained by Granulicatella adiances could be underestimated due to their particular microbiological conditions requested for their cultures. However, this infection should be suspected in cases of culture-negative SD, especially when associated with endocarditis.

Granulicatella adiacens as an Unusual Cause of Empyema: A Case Report and Review of Literature

“…Using the inclusion and exclusion criteria, 24 literature were found relevant and included in the review. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Clinical details of all published literature are compiled in the Table 1 . As per the review of literature of last 10 years, G. adiacens is found to be the cause of various infections such as bacteremia, endocarditis, osteomyelitis, septic arthritis, discitis, prosthetic joint infections, carbuncle, bacterascites (spontaneous bacterial peritonitis), dacryocystitis, and abscess.…”

Spontaneous Vertebral Aspergillosis, the State of Art: A Systematic Literature Review

“…A targeted medical antifungal therapy may result in increased chances for better clinical outcomes in VA, thus the isolation of the involved pathogen is strongly recommended. Percutaneous sampling under radiological guidance may represent a useful alternative to open biopsy [ 2 ]. However, worsening neurological symptoms and/or poor response to medical therapies may lead to surgical decompression [ 2 ].…”

“…Percutaneous sampling under radiological guidance may represent a useful alternative to open biopsy [ 2 ]. However, worsening neurological symptoms and/or poor response to medical therapies may lead to surgical decompression [ 2 ]. Surgery may be useful to achieve a solid fusion and deformity correction in case of spinal instability or vertebral collapse and obtain a microbiological sample to reach the diagnosis in case of negative needle biopsy [ 100 - 102 ].…”

“…Vertebral mycoses are subtypes of vertebral osteomyelitis (VO) that represent rare and severe life-threatening conditions, requiring long-term pharmacological therapy and often surgical treatments [ 1 , 2 ]. Aspergillus species are ubiquitous fungi.…”

Liver abscess due to Granulicatella adiacens in an immunocompetent patient: Case report

“…The most common causes of pyogenic liver abscesses are abdominal infections such as appendicitis or peritonitis, bacteremia, bile duct infection and trauma, when no cause or risk factor associated with the abscess is found, it is described as cryptogenic 1 . The main microorganisms associated with liver abscesses are Klebsiella pneumoniae, Streptococcus milleri, Escherichia coli, Burkholderia pseudomallei and Staphylococcus aureus 2 , 3 .…”