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Proteus mirabilis thoracic vertebral osteomyelitis: a case report.

Ming-Hsiu Chiang¹, Mei-Hui Lee², Yung-Ching Liu^2,3

¹School of Medicine, College of Medicine, Taipei Medical University, No. 250, Wuxing St., Xinyi Dist., Taipei, 110, Taiwan.

Journal of Medical Case Reports

|May 28, 2021

Summary

Proteus mirabilis, a common UTI pathogen, can cause vertebral osteomyelitis, leading to chronic back pain. This case highlights effective antibiotic treatment for this rare but serious infection in an elderly patient.

Keywords:

Bacteremia Case report Osteomyelitis Proteus mirabilis Thoracic vertebrae

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Published on: October 25, 2024

Area of Science:

Infectious Diseases
Orthopedic Surgery
Internal Medicine

Background:

Proteus mirabilis is a common cause of urinary tract infections.
Vertebral osteomyelitis is a rare but serious complication of P. mirabilis infections.
Retrograde dissemination via paravertebral venous plexus is a potential mechanism.

Observation:

An 80-year-old woman presented with chronic back pain and recurrent fevers.
Blood cultures identified P. mirabilis.
Imaging revealed a vertebral lesion between the seventh and eighth thoracic vertebrae.

Findings:

The patient responded well to antibiotic therapy.
Significant relief of back pain and no fever recurrence at 4-month follow-up.
Long-term antibiotics are effective for P. mirabilis osteomyelitis.

Implications:

Osteomyelitis should be considered in elderly patients with chronic back pain and recurrent fever.
Predisposing factors include old age, chronic renal failure, and diabetes.
Antibiotics are effective; surgery may be needed for abscesses or severe vertebral destruction.