Vertebral Osteomyelitis Caused by Prevotella (Bacteroides) Melaninogenicus

Mukhopadhyay, Surabhi; Rose, Fredrick; Frechette, Vincent

doi:10.1097/01.smj.0000140855.39444.07

“…The hematogenous spread of Prevotella spp. may be transient, but can occasionally lead to the dissemination of these microorganisms in various organs and tissues and, consequently, to the development of distant infection sites, such as endocarditis, infected pseudoaneurysm, and liver, lung and brain abscesses, as well as osteoarticular infections [115,[127][128][129][130][131][132][133][168][169][170][171][172][173][174][175][176][177].…”

Section: New Insights Into Prevotella Diversity and Medical Microbiologmentioning

confidence: 99%

New Insights into Prevotella Diversity and Medical Microbiology

Alauzet¹,

Marchandin

²

,

Lozniewski³

2010

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In light of recent studies based on cultivation-independent methods, it appears that the diversity of Prevotella in human microbiota is greater than was previously assumed from cultivation-based studies, and that the implication of these bacteria in several human diseases was unrecognized. While some Prevotella taxa were found during opportunistic infections, changes in Prevotella abundance and diversity were discovered during dysbiosis-associated diseases. As member of the microbiota, Prevotella may also be considered as a reservoir for resistance genes. Greater knowledge on Prevotella diversity, as well as new insights into its pathogenic potential and implication in dysbiosis are expected from the use of human microbe identification microarrays, from whole-genome sequence analyse, and from the NIH Human Microbiome Project data. New approaches, including molecular-based methods, could contribute to improve the diagnosis of Prevotella infections.

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“…A review of literature on available data on anaerobic osteomyelitis with Prevotella isolates shows only nine cases reported till date. [8][9][10][11][12][13][14][15][16] Among this only one case reports secondary Prevotella infection on chronic tubercular vertebral osteomyelitis. A summary of the data available on Anaerobic osteomyelitis with prevotella isolates are shown in Table 1.…”

Section: Discussionmentioning

confidence: 99%

The cocktail infection: anaerobic and aerobic co-Infections in tubercular vertebral osteomyelitis

Bhat

¹

,

Kundangar

²

,

Ampar

³

et al. 2022

F1000Res

1

0

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Background: Anaerobic organisms have been known to have an association with dental infections, bacteremia, endocarditis and soft tissue infections. However, anaerobic isolation from bone and joint infections are relatively rare. Sparse literature has been found on reports of anaerobic osteomyelitis. There is no literature reported on anaerobic osteomyelitis complicating Tuberculosis of spine. Case Report: We report two cases of tuberculosis of spine complicated by aerobic and anerobic infections. The first is a case of a young female who presented with chronic lower backache and fever. Examination revealed a lumbar scoliosis with paraspinal tenderness. Magnetic resonance imaging (MRI) of the spine showed lumbar spondylodiscitis with multiple abscesses. There were air-fluid levels noted in the abscesses. The pus sent for CBNAAT (cartridge based nucleic acid amplification test) was positive. Further the cultures also grew Escherichia coli (aerobic) Bacteroids fragilis and Peptoniphilus asachrolyticus (anaerobic) organisms. She improved with a course of intravenous antibiotics and decompression surgery. The second case is a middle aged man who presented with chronic neck pain and fever. Examination revealed kyphosis of the neck with spasm of the neck muscles and midline tenderness. MRI showed C4-5 cervical spondylodiscitis with parapharyngeal collections showing air-fluid levels. The pus culture showed Streptococcus constellatus (aerobic) and Prevotella sps. (anaerobic). The CBNAAT report was positive for Mycobacterium tuberculosis. The patient was treated with intravenous antibiotics and cervical decompression. Conclusion: Though tubercular vertebral osteomyelitis (TVO) is usually a diagnosis in itself, it should not hinder us from considering secondary infections (both aerobic and anaerobic) complicating the osteomyelitis. Further, the presence of air-fluid levels on imaging studies and the presence of foul smell during operative exploration of the spine must arouse the suspicion of an anaerobic co-infection. Isolation and treatment of these organisms are crucial as they may hamper the clinical outcome of the primary TVO.

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“…A review of literature on available data on anaerobic osteomyelitis with Prevotella isolates shows only nine cases reported till date. [8][9][10][11][12][13][14][15][16] Among this only one case reports secondary Prevotella infection on chronic tubercular vertebral osteomyelitis. A summary of the data available on Anaerobic osteomyelitis with prevotella isolates are shown in Table 1.…”

Section: Discussionmentioning

confidence: 99%

The cocktail infection: anaerobic and aerobic co-Infections in tubercular vertebral osteomyelitis

Bhat

¹

,

Kundangar

²

,

Ampar

³

et al. 2022

F1000Res

1

0

View full text Add to dashboard Cite

Background: Anaerobic organisms have been known to have an association with dental infections, bacteremia, endocarditis and soft tissue infections. However, anaerobic isolation from bone and joint infections are relatively rare. Sparse literature has been found on reports of anaerobic osteomyelitis. There is no literature reported on anaerobic osteomyelitis complicating Tuberculosis of spine. Case Report: We report two cases of tuberculosis of spine complicated by aerobic and anerobic infections. The first is a case of a young female who presented with chronic lower backache and fever. Examination revealed a lumbar scoliosis with paraspinal tenderness. Magnetic resonance imaging (MRI) of the spine showed lumbar spondylodiscitis with multiple abscesses. There were air-fluid levels noted in the abscesses. The pus sent for CBNAAT (cartridge based nucleic acid amplification test) was positive. Further the cultures also grew Escherichia coli (aerobic) Bacteroids fragilis and Peptoniphilus asachrolyticus (anaerobic) organisms. She improved with a course of intravenous antibiotics and decompression surgery. The second case is a middle aged man who presented with chronic neck pain and fever. Examination revealed kyphosis of the neck with spasm of the neck muscles and midline tenderness. MRI showed C4-5 cervical spondylodiscitis with parapharyngeal collections showing air-fluid levels. The pus culture showed Streptococcus constellatus (aerobic) and Prevotella sps. (anaerobic). The CBNAAT report was positive for Mycobacterium tuberculosis. The patient was treated with intravenous antibiotics and cervical decompression. Conclusion: Though tubercular vertebral osteomyelitis (TVO) is usually a diagnosis in itself, it should not hinder us from considering secondary infections (both aerobic and anaerobic) complicating the osteomyelitis. Further, the presence of air-fluid levels on imaging studies and the presence of foul smell during operative exploration of the spine must arouse the suspicion of an anaerobic co-infection. Isolation and treatment of these organisms are crucial as they may hamper the clinical outcome of the primary TVO.

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Vertebral Osteomyelitis Caused by Prevotella (Bacteroides) Melaninogenicus

Cited by 8 publications

References 9 publications

New Insights into Prevotella Diversity and Medical Microbiology

New Insights into Prevotella Diversity and Medical Microbiology

The cocktail infection: anaerobic and aerobic co-Infections in tubercular vertebral osteomyelitis

The cocktail infection: anaerobic and aerobic co-Infections in tubercular vertebral osteomyelitis

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