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Vertebral osteomyelitis associated with Granulicatella adiacens
Ryuki Fukuda1, Masayuki Oki, Akihiro Ueda
1Department of General Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan. f.ryuki@is.icc.u-tokai.ac.jp
The Tokai Journal of Experimental and Clinical Medicine
|February 15, 2011
Summary
Granulicatella adiacens, a rare cause of vertebral osteomyelitis, typically presents with infective endocarditis. This case highlights the first instance of vertebral osteomyelitis caused by G. adiacens without infective endocarditis.
Area of Science:
- Infectious Diseases
- Microbiology
- Orthopedics
Background:
- Granulicatella adiacens, a nutritionally variant streptococci (NVS), is an uncommon cause of infection.
- Vertebral osteomyelitis is a serious spinal infection, with NVS infections being exceptionally rare.
Observation:
- A 73-year-old male presented with fever and back pain, diagnosed with lumbar vertebral osteomyelitis.
- Echocardiography revealed mitral valve prolapse, but no vegetation, differentiating from typical infective endocarditis.
- Blood cultures identified G. adiacens as the causative agent.
Findings:
- This report details the first documented case of vertebral osteomyelitis caused by G. adiacens without concurrent infective endocarditis.
- The patient successfully responded to combination antibiotic therapy and subsequent valvoplasty.
- Unlike previous reports, the resected mitral valve showed no signs of infection.
Implications:
- The findings underscore the importance of considering NVS in vertebral osteomyelitis cases, especially with positive Gram stains but negative blood cultures.
- Misdiagnosis is a risk due to the fastidious growth requirements of NVS in standard culture media.
- Early recognition and appropriate treatment are crucial for favorable outcomes in NVS-related vertebral osteomyelitis.
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