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Streptomyces morookaense spinal suppurative infection: a case report.
Liyang Wu1, Jiahao Pu2, Xinhua Xi1
1The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, Guangdong, 512026, China.
BMC Infectious Diseases
|April 3, 2026
Summary
A rare thoracic vertebral infection caused by Streptomyces morookaense in an immunocompetent patient highlights the need for advanced diagnostics. Metagenomic sequencing aided in identifying this unusual pathogen, guiding effective treatment.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Spinal Surgery
Background:
- Streptomyces species are common soil bacteria and a significant source of antibiotics.
- Invasive human infections by Streptomyces are rare, especially those affecting the spine, often mimicking other conditions like tuberculosis or fungal infections.
- Spinal infections require accurate diagnosis for effective treatment, as misdiagnosis can lead to prolonged illness and complications.
Purpose of the Study:
- To report a case of thoracic suppurative vertebral infection caused by Streptomyces morookaense.
- To highlight an integrated diagnostic approach for rare spinal infections.
- To emphasize the potential of Streptomyces morookaense to cause severe infections in immunocompetent individuals.
Main Methods:
- A 66-year-old immunocompetent woman presented with progressive thoracic back pain after trauma.
- Imaging (CT/MRI) revealed vertebral destruction and paravertebral abscess at T3-T4.
- Fluoroscopy-guided percutaneous biopsy was performed for histopathology, culture, and metagenomic next-generation sequencing (mNGS).
Main Results:
- Histopathology showed non-specific inflammation; acid-fast staining was negative.
- Vertebral tissue culture identified Streptomyces spp.
- Metagenomic next-generation sequencing (mNGS) confirmed high-abundance sequences of Streptomyces morookaense.
- Intravenous piperacillin/tazobactam resulted in rapid clinical improvement and normalization of inflammatory markers.
Conclusions:
- Streptomyces morookaense can cause thoracic spine infections in immunocompetent individuals.
- Percutaneous vertebral sampling combined with pathology, culture, and mNGS improves the detection of rare pathogens in unexplained spinal infections.
- This integrated approach can prevent inappropriate empirical therapies and guide targeted treatment for complex spinal infections.
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