Spondylodiscitis due to Propionibacterium acnes: report of twenty-nine cases and a review of the literature

Autor: J. Biziragusenyuka, Louis Bernard, Pierre Hoffmeyer, Peter Rohner, A. Riche, Saloua Mammou, Martin Rottman, Ilker Uçkay, A. Dinh, Richard Stern, N. Asseray, Laetitia Vauthey, D. Wendling, N. Passuti
Přispěvatelé: Laboratoire de microbiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratory of Chemical Physics, National Institute of Chemical Physics and Biophysics = Keemilise ja bioloogilise füüsika instituut [Estonie] (NICPB | KBFI), Service de Médecine Aiguë Spécialisée
Rok vydání: 2009
Předmět:
Male
0302 clinical medicine
Back pain
030212 general & internal medicine
MESH: Aged
0303 health sciences
MESH: Middle Aged
biology
case series
MESH: Propionibacterium acnes
General Medicine
Middle Aged
3. Good health
Infectious Diseases
[SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system
MESH: Young Adult
Female
medicine.symptom
MESH: Spine
Spondylodiscitis
Microbiology (medical)
Adult
medicine.medical_specialty
Discitis
Epidural abscess
Adolescent
03 medical and health sciences
Propionibacterium acnes
Young Adult
Pharmacotherapy
medicine
Humans
Anaerobes
Spondylitis
Gram-Positive Bacterial Infections
Aged
MESH: Adolescent
MESH: Humans
Osteosynthesis
030306 microbiology
business.industry
MESH: Adult
medicine.disease
biology.organism_classification
MESH: Male
Spine
Surgery
MESH: Discitis
MESH: Gram-Positive Bacterial Infections
spondylodiscitis
business
MESH: Female
Zdroj: Clinical Microbiology and Infection
Clinical Microbiology and Infection, Elsevier for the European Society of Clinical Microbiology and Infectious Diseases, 2010, 16 (4), pp.353-8. ⟨10.1111/j.1469-0691.2009.02801.x⟩
ISSN: 1469-0691
1198-743X
DOI: 10.1111/j.1469-0691.2009.02801.x⟩
Popis: International audience; Propionibacterium acnes is the most frequent anaerobic pathogen found in spondylodiscitis. A documented case required microbiological proof of P. acnes with clinical and radiological confirmation of inflammation in a localized region of the spine. Microbiological samplings were obtained by surgery or aspiration under radiological control. Twelve males and 17 females (median age, 42 years) with spondylodiscitis due to P. acnes were diagnosed within the last 15 years. Three patients were immunosuppressed. All patients reported back pain as the main symptom, and most were afebrile. Three patients had a peripheral neurological deficit, one a motor deficit, and two a sensory deficit attributable to the infection; and six patients had an epidural abscess. The most frequent risk factor was surgery, which was present in the history 28 of 29 (97%) patients. The mean delay between spinal surgery and onset of disease was 34 months, with a wide range of 0-156 months. Osteosynthesis material was present in twenty-two cases (76%). In 24 (83%) patients, additional surgery, such as débridement or spondylodesis, was performed. Previous osteosynthesis material was removed in 17 of the 22 (77%) patients where it was present. Total cure was reported in all patients, except one, after a mean duration of antibiotic therapy of 10.5 weeks (range, 2-28 weeks). In conclusion, spondylodiscitis due to P. acnes is an acute infection closely related to previous surgery. The most prominent clinical feature is pain, whereas fever is rare, and the prognosis is very good.
Databáze: OpenAIRE
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