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Bilateral Shoulder Infections and Delayed Recognition of Spinal Discitis in an Adult Male With Mild COVID-19 and
John G Skedros1, Jessie A Montgomery2, John T Cronin1
1Shoulder and Elbow, Utah Orthopaedic Specialists, Salt Lake City, USA.
Abstract:
Coronavirus disease 2019 (COVID-19) has been associated with numerous complications beyond the respiratory tract, including spinal and joint co-infections and secondary infections. However, we could not locate any reported cases of bilateral shoulder infections with additional spinal infections associated with mild (like our patient) COVID-19 or with more severe cases of COVID-19. We report the case of a healthy 62-year-old male who presented with mild COVID-19 and concurrent methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia associated with multiple musculoskeletal sites of deep-seated infection. These included bilateral shoulder infections and delayed detection of lumbar spondylodiscitis with spinal epidural abscess (SEA). The patient had no known risk factors for complicated MSSA bacteremia. We discuss the potential pathophysiology and highlight the increased risk for worse outcomes in patients with mild COVID-19 and bacterial co-infections. This case is not only unique but provides valuable insight for physicians tasked with making difficult diagnoses that may be masked or complicated by COVID-19 infection.
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Etiology
Three primary contributing factors have been identified.
Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...

