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Pyogenic discitis due to Abiotrophia adiacens.

Kosuke Uehara1, Hirotaka Chikuda, Yoshimi Higurashi

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Abiotrophia adiacens, a nutritionally variant bacteria, can cause spinal infections. Supplemented media are crucial for identifying this pathogen, often missed in conventional cultures.

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Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Spinal Infections

Background:

  • Abiotrophia species are nutritionally variant bacteria with fastidious growth requirements.
  • Conventional culture methods often fail to identify Abiotrophia species due to their slow growth and specific needs.

Purpose of the Study:

  • To report a case of spinal discitis caused by Abiotrophia adiacens.
  • To highlight the diagnostic challenges and importance of specialized media for identifying Abiotrophia species in clinical settings.

Main Methods:

  • A patient with severe low back pain and fever underwent MRI, revealing discitis.
  • Needle biopsy of the intervertebral disc and blood cultures were performed.
  • Identification of Abiotrophia adiacens was achieved through subculture on supplemented media and 16S ribosomal RNA gene sequencing.

Main Results:

  • Abiotrophia adiacens was identified as the causative agent of spinal discitis.
  • The patient successfully responded to intravenous ampicillin treatment.
  • The study underscores the difficulty in culturing Abiotrophia species using standard methods.

Conclusions:

  • Nutritionally supplemented media, such as Brucella HK agar or GAM agar, are essential for detecting Abiotrophia species.
  • Many cases of Abiotrophia discitis may be misclassified as culture-negative, potentially underestimating the pathogen's role in pyogenic discitis.