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Spinal abscess and spondylitis due to actinomycosis
L Voisin1, O Vittecoq, O Mejjad
1Department of Rheumatology, Rouen University Hospital, France.
Spine
|March 28, 1998
Summary
Spinal actinomycosis, a rare infection, presents diagnostic challenges. Early antibiotic treatment, like ofloxacin and rifampicin, significantly improves outcomes for this vertebral condition.
Area of Science:
- Medical Case Study
- Infectious Diseases
- Spinal Pathology
Background:
- Spinal actinomycosis is an uncommon infection, typically arising from contiguous spread from abdominal, pelvic, or thoracic regions.
- This spinal localization accounts for less than 5% of all actinomycosis cases.
- Historically, spinal actinomycosis was often a postmortem diagnosis before the advent of antibiotics.
Observation:
- A 34-year-old immunocompetent woman presented with fever, cough, thoracic pain, and severe back pain.
- Imaging revealed lytic lesions on T11-T12 vertebral bodies and a paravertebral mass.
- A surgical biopsy of the affected vertebra and abscess was performed.
Findings:
- Histopathological examination of biopsy tissue showed characteristic sulfur granules and gram-positive filamentous bacteria.
- Actinobacillus actinomycetemcomitans was isolated from cultures, confirming vertebral actinomycosis.
- The patient experienced significant symptom relief after a 3-month course of ofloxacin and rifampicin.
Implications:
- This case highlights the diagnostic difficulties associated with spinal actinomycosis.
- Effective antibiotic therapy has transformed the prognosis of this rare spinal infection.
- Prompt diagnosis and treatment are crucial for managing spinal actinomycosis effectively.