A Case of Pyogenic Spondylitis Due to Aggregatibacter aphrophilus.
- Author:
Kye Hyung KIM
1
;
Namhee KIM
;
Kyung Hwa SHIN
;
Shine Young KIM
;
Chulhun L CHANG
;
Jongyoun YI
Author Information
- Publication Type:Case Report
- Keywords: Aggregatibacter aphrophilus; Pyogenic spondylitis; Vertebral osteomyelitis
- MeSH: Aggregatibacter aphrophilus*; Back Pain; Bacteria; C-Reactive Protein; Echocardiography; Endocarditis; Fever; Humans; Inflammation; Korea; Leukocytosis; Magnetic Resonance Imaging; Middle Aged; Mouth; Psoas Abscess; Retinaldehyde; RNA, Ribosomal, 16S; Spine; Spondylitis*; Suppuration
- From:Annals of Clinical Microbiology 2014;17(3):99-103
- CountryRepublic of Korea
- Language:Korean
- Abstract: Aggregatibacter aphrophilus, a normal component of oral cavity flora, mostly causes infective endocarditis and only rarely causes spondylitis; no spondylitis cases have been previously reported in Korea. We report a case of pyogenic spondylitis due to A. aphrophilus without endocarditis. A 64-year-old man was admitted for back pain lasting 3 weeks. There was severe tenderness on lumbar spines but no fever. Laboratory evaluation showed leukocytosis and elevated C-reactive protein. Blood cultures were negative. Magnetic resonance imaging showed psoas abscess and vertebral inflammation. Pus was obtained by computerized tomography-guided aspiration from the psoas abscess and inoculated into blood culture bottles. After 5 days of incubation, growth was detected: the isolate was a Gram-negative short rod bacteria identified as A. aphrophilus by the automated system; this was confirmed by 16S ribosomal RNA sequencing. There was no evidence of endocarditis in echocardiography and retinal examination. Back pain persisted despite 8 weeks of antibiotic treatment, so vertebral corpectomy was performed. A. aphrophilus, a rare cause of pyogenic spondylitis, can induce spondylitis without endocarditis. If a patient with pyogenic spondylitis shows negative routine bacterial cultures, fastidious organisms such as A. aphrophilus should be suspected and the blood culture bottles could be used.
