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Enterobacter agglomerans spondylodiscitis: a possible, unrecognized complication of tetracycline therapy
1Department of Orthopaedics, Airedale General Hospital, Keighley, United Kingdom.
Study Design:
This case report describes infection in a lumbar disc in a healthy young man with an organism of low pathogenicity. The patient was taking a prolonged course of antibiotics at the time the infection occurred.
Objective:
To describe this unique case of infective spondylodiscitis.
Summary Of Background Data:
To the authors' knowledge, spinal infection with Enterobacter agglomeranshas never been reported. This organism is a transient gut colonizer, and may have established itself secondary to the patient's prolonged ingestion of tetracycline for acne.
Methods:
This 22-year-old farmer had spontaneous lumbar back pain. Radiologic investigations showed an abnormality in the L4-L5 disc region, and together with other investigations, were suggestive of infection. The diagnosis was confirmed by surgical aspiration.
Results:
Antibiotic therapy was administered, and the patient made a complete recovery. Follow-up radiographs showed a complete loss of the L4-L5 disc space with only minimal bone destruction.
Conclusion:
A unique cause of infective lumbar discitis is presented. Several features of this case are unusual. The magnetic resonance findings were not readily diagnostic. The cultured organism is usually nonpathogenic. The infection may have been secondary to prolonged tetracycline therapy.
Insights
A rare case of lumbar disc infection caused by the usually nonpathogenic Enterobacter agglomerans occurred in a young man. Prolonged antibiotic use may have contributed to this unique spinal infection.
Area of Science:
- Infectious Diseases
- Spinal Infections
- Microbiology
Background:
- Spinal infection with Enterobacter agglomerans is unprecedented.
- Enterobacter agglomerans, a gut colonizer, may have infected the lumbar disc secondary to prolonged tetracycline use for acne.
Observation:
- A 22-year-old farmer presented with spontaneous lumbar back pain.
- Radiological findings indicated an abnormality in the L4-L5 disc region, suggestive of infection.
- Diagnosis was confirmed via surgical aspiration.
Findings:
- The patient received antibiotic therapy and achieved a full recovery.
- Follow-up radiographs revealed complete loss of the L4-L5 disc space with minimal bone destruction.
Implications:
- This case highlights a unique cause of infective spondylodiscitis.
- Unusual features include the nonpathogenic nature of the organism and non-diagnostic MRI findings.
- Prolonged tetracycline therapy is a potential contributing factor.