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Maternal group B streptococcal vertebral osteomyelitis: an unusual complication of vaginal delivery
1Department of Obstetrics and Gynecology, Scripps Memorial Hospital, La Jolla, California.
A 42-year-old woman developed severe neck pain 20 hours postpartum. She had cervical spondylitis from an accident 15 years earlier. An elevated sedimentation rate was the only abnormal laboratory finding. Vertebral osteomyelitis was diagnosed by magnetic resonance imaging 12 days postpartum. She underwent radical debridement of C5 and C6 with anterior fusion because of neurologic deterioration and extensive vertebral destruction. A posterior fusion was performed 7 days later for additional stabilization. Group B streptococci were cultured from the debridement tissue. The patient received 8 weeks of intravenous antibiotics. Residual disability at 3 months involved minimal dysesthesia of all extremities.
A 42-year-old woman developed severe neck pain 20 hours postpartum. She had cervical spondylitis from an accident 15 years earlier. An elevated sedimentation rate was the only abnormal laboratory finding. Vertebral osteomyelitis was diagnosed by magnetic resonance imaging 12 days postpartum. She underwent radical debridement of C5 and C6 with anterior fusion because of neurologic deterioration and extensive vertebral destruction. A posterior fusion was performed 7 days later for additional stabilization. Group B streptococci were cultured from the debridement tissue. The patient received 8 weeks of intravenous antibiotics. Residual disability at 3 months involved minimal dysesthesia of all extremities.