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[Spondylodiscitis caused by a strain of Staphylococcus aureus, in vitro sensitive to penicillin]

Jirí Benes1, Mária Kabelková, Jana Kotlíková

  • 1Department of Infectious Diseases, 3rd Medical Faculty, Charles University Prague, Budínova 2, 180-81 Prague 8, Czech Republic. benes@cesnet.cz

Klinicka Mikrobiologie a Infekcni Lekarstvi
|November 24, 2004
PubMed

Insights

A patient with suspected meningitis had lumbar spondylodiscitis caused by Staphylococcus aureus. Despite penicillin sensitivity, treatment failed, highlighting challenges in severe staphylococcal infections.

Area of Science:

  • Infectious Diseases
  • Neurosurgery
  • Orthopedic Surgery

Background:

  • This case highlights a diagnostic challenge where initial symptoms suggested purulent meningitis.
  • The actual diagnosis was spondylodiscitis of the lumbar spine with extensive spread.

Observation:

  • A patient presented with symptoms mimicking meningitis but was found to have lumbar spondylodiscitis.
  • The infection involved the spinal canal and the left psoas muscle, caused by Staphylococcus aureus.
  • In vitro testing showed the Staphylococcus aureus strain was sensitive to penicillin.

Findings:

  • Treatment with crystalline penicillin and ciprofloxacin was ineffective.
  • The study emphasizes the importance of differentiating spinal epidural abscess from meningitis.
  • Penicillin is not recommended for severe staphylococcal infections, even with in vitro sensitivity.

Implications:

  • This case underscores the need for accurate differential diagnosis in spinal infections.
  • It questions the clinical utility of penicillin in severe Staphylococcus aureus infections.
  • Findings may influence treatment guidelines for complex spinal infections.

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