Burkholderia cepacia Complex Lumbar Spondylodiscitis: A Rare Nosocomial Infection

Rachel Subramanian1, Lynn Fitzgibbons2

  • 1Department of Medical Education, Santa Barbara Cottage Hospital, Santa Barbara, CA, USA.

Insights

Pyogenic spondylodiscitis caused by Burkholderia cepacia complex is rare. An immunocompetent woman with hyperthyroidism was successfully treated with levofloxacin for this rare spinal infection.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Microbiology

Background:

  • Pyogenic spondylodiscitis is a spinal infection, rarely caused by Burkholderia cepacia complex.
  • Burkholderia cepacia complex is an opportunistic pathogen, typically affecting immunocompromised individuals or those with cystic fibrosis.

Observation:

  • A female patient with hyperthyroidism developed lower back pain post-bariatric surgery.
  • Lumbar MRI revealed L2/L3 osteomyelitis and discitis.
  • Aspiration culture identified Burkholderia cepacia complex.

Findings:

  • The identified Burkholderia cepacia complex strain showed sensitivity to multiple antibiotics.
  • Initial treatment with cefepime was ineffective.
  • Successful treatment was achieved with levofloxacin monotherapy.

Implications:

  • This case highlights a rare instance of Burkholderia cepacia complex causing spondylodiscitis in an immunocompetent host.
  • It underscores the importance of considering environmental pathogens in post-surgical infections.
  • Levofloxacin monotherapy can be an effective treatment option for this specific type of infection.

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