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Vertebral osteomyelitis caused by Streptococcus agalactiae
J Solís-Garcia del Pozo1, E Martinez-Alfaro, L Abad
1Department of Internal Medicine, Unit of Infectious Diseases, Albacete General Hospital, Spain.
Abstract:
Streptococcus agalactiae is a rare cause of vertebral osteomyelitis. We present four cases of spondylitis caused by this micro-organism and a review of 20 cases previously described in the literature. Only seven patients (29%) were under 50 years of age. Diabetes mellitus and neoplasms were the most frequent underlying conditions, although 37.5% of the patients did not have any predisposition. Neck or back pain was the most common symptom. Diagnosis depended mainly on magnetic resonance imaging. Blood cultures were positive in 50% of the patients. The duration of antibiotic therapy was 6 weeks for most patients. The outcome was favourable, with none of the patients suffering serious sequelae.
Insights
Streptococcus agalactiae is a rare cause of vertebral osteomyelitis. This study reviewed 24 cases, finding that while older adults with diabetes or neoplasms are most affected, diagnosis via MRI and 6-week antibiotic treatment leads to favorable outcomes.
Area of Science:
- Infectious Diseases
- Orthopedics
- Microbiology
Background:
- Vertebral osteomyelitis is typically caused by other bacteria.
- Streptococcus agalactiae (Group B Streptococcus) is an uncommon pathogen for this condition.
Observation:
- This study presents four new cases and reviews 20 previously reported cases of vertebral osteomyelitis caused by Streptococcus agalactiae.
- The majority of patients (71%) were over 50 years old.
- Common predisposing factors included diabetes mellitus and neoplasms, though a significant portion had no identifiable risk factors.
Findings:
- Neck or back pain was the most frequent presenting symptom.
- Magnetic resonance imaging (MRI) was the primary diagnostic tool.
- Blood cultures yielded positive results in 50% of cases.
- A standard treatment duration of 6 weeks of antibiotics was generally employed.
Implications:
- Highlights Streptococcus agalactiae as a potential, albeit rare, cause of vertebral osteomyelitis.
- Emphasizes the importance of considering less common pathogens in spinal infections.
- Suggests MRI is crucial for diagnosis and that standard antibiotic protocols are effective, leading to good patient outcomes without significant sequelae.