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Spinal and paraspinal pneumococcal infections-a review

D M Siddiq1, D M Musher, R O Darouiche

  • 1Baylor College of Medicine and the Michael E. DeBakey Veteran Affairs Medical Center, 2002 Holcombe Blvd., Room 4B-370, Houston, TX, 77025, USA, danish.m.siddiq@gmail.com.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|February 1, 2014
PubMed

Insights

Spinal infections caused by Streptococcus pneumoniae are rare but serious. This study reviews 52 cases, finding lumbar spine involvement and localized back pain common, with surgical intervention not improving survival.

Area of Science:

  • Infectious Diseases
  • Neurosurgery
  • Orthopedic Surgery

Background:

  • Spinal and paraspinal infections due to Streptococcus pneumoniae are infrequent occurrences.
  • This study examines two institutional cases and reviews an additional 50 cases from existing literature.
  • The analysis encompasses spinal epidural abscess, vertebral osteomyelitis, and paraspinal abscesses caused by pneumococcus.

Observation:

  • The analysis included two institutional cases and a literature review of 50 additional cases.
  • Common manifestations included persistent localized back pain and elevated inflammatory markers.
  • The lumbar spine was the most frequently affected region.

Findings:

  • Streptococcus pneumoniae was most often identified directly from the infection site, with blood cultures being less sensitive.
  • Patients with neurological deficits, particularly those with spinal epidural abscess or phlegmon, exhibited higher mortality rates.
  • A 6-week course of parenteral antimicrobials was the standard treatment.

Implications:

  • Surgical intervention did not demonstrate a mortality benefit in the management of pneumococcal spinal infections.
  • Understanding the clinical course and treatment outcomes is crucial for managing these rare but potentially severe infections.

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