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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
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.
Abstract:
Pyogenic spondylodiscitis is rarely caused by Burkholderia cepacia complex. B. cepacia is widespread in the environment and recognized as an opportunistic pathogen for patients with cystic fibrosis and immune disorders. A female in her mid-30s with underlying hyperthyroidism, but otherwise immunocompetent, was admitted to the hospital with persistent lower back pain after elective bariatric surgery in Mexico. Lumbar MRI showed L2/L3 osteomyelitis and discitis. Culture of disk aspiration grew Burkholderia cepacia complex sensitive to cefepime, ceftazidime, ciprofloxacin, gentamicin, imipenem, levofloxacin, and trimethoprim-sulfamethoxazole. The infection failed to respond to cefepime; however, she was successfully treated with levofloxacin monotherapy.
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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