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Updated: Oct 3, 2025
Generation, Purification, and Characterization of Cell-invasive DISC1 Protein Species
Published on: August 30, 2012
Klebsiella Discitis in a 15-Year-Old Male Diagnosed With Plasma Microbial Cell-Free DNA Next-Generation Sequencing
Farida Karim1, Marmik Patel1, Lori L Barr2
1Pediatrics, Sacred Heart Hospital, Pensacola, USA.
Abstract:
Spinal discitis (SD) is a rare condition, particularly in the pediatric population. The course of SD may be acute or chronic, and the non-specificity of symptoms leads to great delays in diagnosis. The most commonly isolated causative organism is Staphylococcus aureus whereas gram-negative infections are hardly ever reported in the literature. Comorbidities that increase the risk of bacteremia such as diabetes, chronic kidney disease, HIV, and cancer are major risk factors for SD. Hereby, we present an atypical case of SD in a previously healthy 15-year-old male with an unusual organism, Klebsiella aerogenes, diagnosed by plasma microbial cell-free DNA with negative blood cultures. The clinical course was complicated by antibiotic resistance and subsequent development of a ventral epidural abscess requiring readmission followed by surgical drainage of the abscess with a prolonged course of antibiotics.
Insights
Pediatric spinal discitis (SD) is rare and often delayed in diagnosis. This case highlights an unusual *Klebsiella aerogenes* infection diagnosed via cell-free DNA, complicated by antibiotic resistance and abscess formation.
Area of Science:
- Pediatric infectious diseases
- Spinal infections
- Microbiology
Background:
- Spinal discitis (SD) is a rare pediatric condition with non-specific symptoms causing diagnostic delays.
- Staphylococcus aureus is the most common pathogen; gram-negative infections are rarely reported.
- Risk factors include comorbidities associated with bacteremia, such as diabetes, CKD, HIV, and cancer.
Observation:
- An atypical case of SD in a previously healthy 15-year-old male is presented.
- The causative organism identified was *Klebsiella aerogenes*, an unusual pathogen for SD.
- Diagnosis was achieved using plasma microbial cell-free DNA testing, with negative blood cultures.
Findings:
- The patient experienced antibiotic resistance, a common challenge in gram-negative infections.
- A ventral epidural abscess developed, necessitating readmission and surgical intervention.
- A prolonged course of antibiotics was required for treatment.
Implications:
- This case expands the known spectrum of causative organisms in pediatric spinal discitis.
- Plasma microbial cell-free DNA is a valuable diagnostic tool, especially when blood cultures are negative.
- The management highlights the complexities of antibiotic resistance and surgical intervention in pediatric spinal infections.
