Polymicrobial vertebral osteomyelitis after oesophageal biopsy: a case report

Aude Giger; Erlangga Yusuf; Oriol Manuel; Olivier Clerc; Andrej Trampuz

doi:10.1186/s12879-016-1471-9

Polymicrobial vertebral osteomyelitis after oesophageal biopsy: a case report

Aude Giger^*, Erlangga Yusuf, Oriol Manuel, Olivier Clerc, Andrej Trampuz

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND: While most cases of polymicrobial vertebral osteomyelitis are secondary to hematogenous seeding, direct inoculation during spinal surgery and contiguous spread from adjacent soft tissue are also potential routes whereby pathogens may infect the spine.

CASE PRESENTATION: A 74 year-old man presented with an exacerbation of back pain after a fall. His past medical history included hepatocellular and oesophageal carcinoma. Three months earlier he had undergone an endoscopic biopsy of the oesophagus for routine follow-up of his oesophagus carcinoma. He also underwent a vertebroplasty due to suspected pathologic fracture. On admission to hospital, magnetic resonance imaging revealed an infiltrative process at the level of the 5th and 6th thoracic vertebrae. Blood cultures were positive for both Streptococcus mitis and Gemella morbillorum. During his course of antibiotic therapy he developed an abscess at the level of 8th thoracic vertebrae and culture of this abscess grew Candida albicans. He was treated with antibiotics and antifungal drugs and recovered fully.

CONCLUSION: Vertebral osteomyelitis may be caused by direct spread following an oesophageal procedure. Microbiological diagnosis is essential to target the specific pathogen, especially in cases of polymicrobial infection.

Original language	English
Pages (from-to)	141
Journal	BMC Infectious Diseases
Volume	16
DOIs	https://doi.org/10.1186/s12879-016-1471-9
Publication status	Published - 31 Mar 2016
Externally published	Yes

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Polymicrobial vertebral osteomyelitis after oesophageal biopsyFinal published version, 1.2 MBLicence: CC BY

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title = "Polymicrobial vertebral osteomyelitis after oesophageal biopsy: a case report",

abstract = "BACKGROUND: While most cases of polymicrobial vertebral osteomyelitis are secondary to hematogenous seeding, direct inoculation during spinal surgery and contiguous spread from adjacent soft tissue are also potential routes whereby pathogens may infect the spine.CASE PRESENTATION: A 74 year-old man presented with an exacerbation of back pain after a fall. His past medical history included hepatocellular and oesophageal carcinoma. Three months earlier he had undergone an endoscopic biopsy of the oesophagus for routine follow-up of his oesophagus carcinoma. He also underwent a vertebroplasty due to suspected pathologic fracture. On admission to hospital, magnetic resonance imaging revealed an infiltrative process at the level of the 5th and 6th thoracic vertebrae. Blood cultures were positive for both Streptococcus mitis and Gemella morbillorum. During his course of antibiotic therapy he developed an abscess at the level of 8th thoracic vertebrae and culture of this abscess grew Candida albicans. He was treated with antibiotics and antifungal drugs and recovered fully.CONCLUSION: Vertebral osteomyelitis may be caused by direct spread following an oesophageal procedure. Microbiological diagnosis is essential to target the specific pathogen, especially in cases of polymicrobial infection.",

author = "Aude Giger and Erlangga Yusuf and Oriol Manuel and Olivier Clerc and Andrej Trampuz",

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journal = "BMC Infectious Diseases",

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T1 - Polymicrobial vertebral osteomyelitis after oesophageal biopsy

T2 - a case report

AU - Giger, Aude

AU - Yusuf, Erlangga

AU - Manuel, Oriol

AU - Clerc, Olivier

AU - Trampuz, Andrej

PY - 2016/3/31

Y1 - 2016/3/31

N2 - BACKGROUND: While most cases of polymicrobial vertebral osteomyelitis are secondary to hematogenous seeding, direct inoculation during spinal surgery and contiguous spread from adjacent soft tissue are also potential routes whereby pathogens may infect the spine.CASE PRESENTATION: A 74 year-old man presented with an exacerbation of back pain after a fall. His past medical history included hepatocellular and oesophageal carcinoma. Three months earlier he had undergone an endoscopic biopsy of the oesophagus for routine follow-up of his oesophagus carcinoma. He also underwent a vertebroplasty due to suspected pathologic fracture. On admission to hospital, magnetic resonance imaging revealed an infiltrative process at the level of the 5th and 6th thoracic vertebrae. Blood cultures were positive for both Streptococcus mitis and Gemella morbillorum. During his course of antibiotic therapy he developed an abscess at the level of 8th thoracic vertebrae and culture of this abscess grew Candida albicans. He was treated with antibiotics and antifungal drugs and recovered fully.CONCLUSION: Vertebral osteomyelitis may be caused by direct spread following an oesophageal procedure. Microbiological diagnosis is essential to target the specific pathogen, especially in cases of polymicrobial infection.

AB - BACKGROUND: While most cases of polymicrobial vertebral osteomyelitis are secondary to hematogenous seeding, direct inoculation during spinal surgery and contiguous spread from adjacent soft tissue are also potential routes whereby pathogens may infect the spine.CASE PRESENTATION: A 74 year-old man presented with an exacerbation of back pain after a fall. His past medical history included hepatocellular and oesophageal carcinoma. Three months earlier he had undergone an endoscopic biopsy of the oesophagus for routine follow-up of his oesophagus carcinoma. He also underwent a vertebroplasty due to suspected pathologic fracture. On admission to hospital, magnetic resonance imaging revealed an infiltrative process at the level of the 5th and 6th thoracic vertebrae. Blood cultures were positive for both Streptococcus mitis and Gemella morbillorum. During his course of antibiotic therapy he developed an abscess at the level of 8th thoracic vertebrae and culture of this abscess grew Candida albicans. He was treated with antibiotics and antifungal drugs and recovered fully.CONCLUSION: Vertebral osteomyelitis may be caused by direct spread following an oesophageal procedure. Microbiological diagnosis is essential to target the specific pathogen, especially in cases of polymicrobial infection.

U2 - 10.1186/s12879-016-1471-9

DO - 10.1186/s12879-016-1471-9

M3 - Article

C2 - 27036910

SN - 1471-2334

VL - 16

SP - 141

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

ER -

Polymicrobial vertebral osteomyelitis after oesophageal biopsy: a case report

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