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Bacteroides fragilis Bacteremia Complicated by Spondylodiscitis, Spinal Epidural Abscess, and Sepsis: A Case Report

Patient: Male, 63-year-old Final Diagnosis: Spondylodiscitis, spinal epidural abscess and sepsis as a complication of Bacteroides fragilis bacteraemia Symptoms: Fever and altered level of consciousness. Significant thoracic spine pain was also reported during the last three months Medication: — Clin...

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Autores principales: Papaetis, Georgios S., Petridis, Theodosis A., Karvounaris, Stylianos A., Demetriou, Theodora, Lykoudis, Savvas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9210500/
https://www.ncbi.nlm.nih.gov/pubmed/35706345
http://dx.doi.org/10.12659/AJCR.936179
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author Papaetis, Georgios S.
Petridis, Theodosis A.
Karvounaris, Stylianos A.
Demetriou, Theodora
Lykoudis, Savvas
author_facet Papaetis, Georgios S.
Petridis, Theodosis A.
Karvounaris, Stylianos A.
Demetriou, Theodora
Lykoudis, Savvas
author_sort Papaetis, Georgios S.
collection PubMed
description Patient: Male, 63-year-old Final Diagnosis: Spondylodiscitis, spinal epidural abscess and sepsis as a complication of Bacteroides fragilis bacteraemia Symptoms: Fever and altered level of consciousness. Significant thoracic spine pain was also reported during the last three months Medication: — Clinical Procedure: Surgical decompressive therapy, with abscess drainage, combined with appropriate antibiotic therapy for twelve weeks Specialty: Medicine, General and Internal OBJECTIVE: Rare coexistence of disease or pathology BACKGROUND: Pyogenic spondylitis comprises several clinical entities, including native vertebral osteomyelitis, septic discitis, pyogenic spondylodiscitis, and epidural abscess. The lumbar spine is most often infected, followed by the thoracic and cervical areas. It mainly develops (i) after spine surgery; (ii) from history of blunt trauma to the spinal column; (iii) from infections in adjacent structures (such as soft tissues); (iv) from iatrogenic inoculation after invasive procedures (such as lumbar puncture); and (v) from hematogenous bacterial spread to the vertebra (mainly through the venous route). Any delay in diagnosis and treatment can lead to significant spinal cord injury, permanent neurological damage, septicemia, and death. CASE REPORT: We describe a 63-year-old man with no significant past medical history who presented with fever and an altered level of consciousness. Significant thoracic spine pain was also reported during the last 3 months. The final diagnosis was vertebral spondylodiscitis, contiguous spinal epidural abscess, and sepsis due to Bacteroides fragilis bacteremia. Clinical recovery was achieved after surgical decompressive therapy with abscess drainage combined with appropriate antibiotic therapy for 12 weeks. The primary focus of the infection was not clarified, despite all the investigations that were performed. CONCLUSIONS: Spondylodiscitis, spinal epidural abscess, and sepsis as complications of Bacteroides fragilis bacteremia are rare in a patient without any previously known predisposing conditions and without an obvious primary focus. Early diagnosis and proper treatment of anaerobic spondylodiscitis, especially if epidural abscess and sepsis are present, are of great importance to reduce mortality and avoid long-term complications.
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spelling pubmed-92105002022-07-06 Bacteroides fragilis Bacteremia Complicated by Spondylodiscitis, Spinal Epidural Abscess, and Sepsis: A Case Report Papaetis, Georgios S. Petridis, Theodosis A. Karvounaris, Stylianos A. Demetriou, Theodora Lykoudis, Savvas Am J Case Rep Articles Patient: Male, 63-year-old Final Diagnosis: Spondylodiscitis, spinal epidural abscess and sepsis as a complication of Bacteroides fragilis bacteraemia Symptoms: Fever and altered level of consciousness. Significant thoracic spine pain was also reported during the last three months Medication: — Clinical Procedure: Surgical decompressive therapy, with abscess drainage, combined with appropriate antibiotic therapy for twelve weeks Specialty: Medicine, General and Internal OBJECTIVE: Rare coexistence of disease or pathology BACKGROUND: Pyogenic spondylitis comprises several clinical entities, including native vertebral osteomyelitis, septic discitis, pyogenic spondylodiscitis, and epidural abscess. The lumbar spine is most often infected, followed by the thoracic and cervical areas. It mainly develops (i) after spine surgery; (ii) from history of blunt trauma to the spinal column; (iii) from infections in adjacent structures (such as soft tissues); (iv) from iatrogenic inoculation after invasive procedures (such as lumbar puncture); and (v) from hematogenous bacterial spread to the vertebra (mainly through the venous route). Any delay in diagnosis and treatment can lead to significant spinal cord injury, permanent neurological damage, septicemia, and death. CASE REPORT: We describe a 63-year-old man with no significant past medical history who presented with fever and an altered level of consciousness. Significant thoracic spine pain was also reported during the last 3 months. The final diagnosis was vertebral spondylodiscitis, contiguous spinal epidural abscess, and sepsis due to Bacteroides fragilis bacteremia. Clinical recovery was achieved after surgical decompressive therapy with abscess drainage combined with appropriate antibiotic therapy for 12 weeks. The primary focus of the infection was not clarified, despite all the investigations that were performed. CONCLUSIONS: Spondylodiscitis, spinal epidural abscess, and sepsis as complications of Bacteroides fragilis bacteremia are rare in a patient without any previously known predisposing conditions and without an obvious primary focus. Early diagnosis and proper treatment of anaerobic spondylodiscitis, especially if epidural abscess and sepsis are present, are of great importance to reduce mortality and avoid long-term complications. International Scientific Literature, Inc. 2022-06-16 /pmc/articles/PMC9210500/ /pubmed/35706345 http://dx.doi.org/10.12659/AJCR.936179 Text en © Am J Case Rep, 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Papaetis, Georgios S.
Petridis, Theodosis A.
Karvounaris, Stylianos A.
Demetriou, Theodora
Lykoudis, Savvas
Bacteroides fragilis Bacteremia Complicated by Spondylodiscitis, Spinal Epidural Abscess, and Sepsis: A Case Report
title Bacteroides fragilis Bacteremia Complicated by Spondylodiscitis, Spinal Epidural Abscess, and Sepsis: A Case Report
title_full Bacteroides fragilis Bacteremia Complicated by Spondylodiscitis, Spinal Epidural Abscess, and Sepsis: A Case Report
title_fullStr Bacteroides fragilis Bacteremia Complicated by Spondylodiscitis, Spinal Epidural Abscess, and Sepsis: A Case Report
title_full_unstemmed Bacteroides fragilis Bacteremia Complicated by Spondylodiscitis, Spinal Epidural Abscess, and Sepsis: A Case Report
title_short Bacteroides fragilis Bacteremia Complicated by Spondylodiscitis, Spinal Epidural Abscess, and Sepsis: A Case Report
title_sort bacteroides fragilis bacteremia complicated by spondylodiscitis, spinal epidural abscess, and sepsis: a case report
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9210500/
https://www.ncbi.nlm.nih.gov/pubmed/35706345
http://dx.doi.org/10.12659/AJCR.936179
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