Spontaneous corynebacterium discitis in a patient with chronic renal failure

Abstract

Study design: Case report describing spontaneous Corynebacterium diptheria discitis in a patient with chronic renal failure. Objectives: To describe this very rare form of discitis and the results of surgical and antibiotic therapy. Setting: University Department of Neurosurgery, Turkey. Case report: A 55-year-old man with chronic renal failure presented with acute low-back pain. Lumbar magnetic resonance imaging (MRI) suggested discitis and osteomyelitis at the L5-S1 level. The L5-S1 disc was operated upon and the discectomy material was sent for pathological and microbiological analysis. Results: Pathological examination revealed infection and bacterial culture grew C. diptheria. The patient was prescribed combination antibiotic therapy with vancomycin, a third-generation cephalosporin, and rifampicin. Clinical status improved after 8 weeks of therapy. Lumbar MRI revealed remission of the discitis and osteomyelitis after 10 months of follow-up. Conclusion: Chronic renal failure patients with low-back pain should be investigated for spinal infection. These individuals are prone to low-grade infection in the form of discitis or osteomyelitis. Corynebacterium subspecies rarely cause spontaneous discitis. This case is interesting because of the unusual causal organism and the occurrence of discitis in the setting of chronic renal failure.

Espondilodiscitis en posible relación con acupuntura. A proposito de un caso

“…10 Atalay B et al describieron un caso de espondilodiscitis por Corynebacterium sp en pacientes con insuficiencia renal 11 . En conclusión, la acupuntura es una técnica en auge no exenta de complicaciones 12 , algunas de ellas potencialmente graves, como la espondilodiscitis infecciosa; por lo que se recomienda estar alerta a las mismas, para un diagnóstico y tratamiento precoces que reduzcan la morbimortalidad en los pacientes afectados.…”

Spontaneouscorynebacteriumspondylodiskitis in an immunocompetent patient: A case report and literature review

“…Underlying diseases like prolonged neutropenia, hematologic malignancy, chronic renal failure, chemotherapy, history of prior spinal trauma or surgery, solid-organ transplantation, and conditions that require long-term use of immunosuppressive agents are the most predisposing factors. 7,[10][11][12][13] In another study, Cebrián et al…”

“…The incidence of spontaneous discitis has risen over the past several years due to an increase in the overall frequency of pyogenic infections. [7][8][9] Hematogeneous spread is the most involved mechanism for spontaneous spondylodiskitis. Underlying diseases like prolonged neutropenia, hematologic malignancy, chronic renal failure, chemotherapy, history of prior spinal trauma or surgery, solid-organ transplantation, and conditions that require long-term use of immunosuppressive agents are the most predisposing factors.…”

“…5,6 A wide spectrum of microorganisms, such as Staphylococcus aureus (S. aureus), coagulase-negative staphylococci (CoNS), streptococci, gram-negative bacilli, Mycobacterium species, and fungi are responsible for spondylodiskitis. 7,8 Corynebacterium subspecies cause these infections very rarely, and up to now, only three cases of patients who had positive medical or surgical history have previously been reported. [7][8][9] According to our knowledge we describe the first case of spontaneous Corynebacterium spondylodiskitis without any history of medical problem, immunodeficiency or drug use/abuse.…”

“…7,8 Corynebacterium subspecies cause these infections very rarely, and up to now, only three cases of patients who had positive medical or surgical history have previously been reported. [7][8][9] According to our knowledge we describe the first case of spontaneous Corynebacterium spondylodiskitis without any history of medical problem, immunodeficiency or drug use/abuse.…”