Spontaneous spondylodiscitis and epidural abscess due to Listeria monocytogenes in a middle-aged patient with gentamicin related side effects: A case report and a review of literature

INTRODUCTION: Primary spondylodiscitis due to Listeria monocytogenes (LM) is a rare condition. RESEARCH QUESTION: We present a case of spontaneous LM spondylodiscitis with an epidural abscess in a middle-aged man, who reported no gastrointestinal infection. MATERIAL AND METHODS: We identified 5 spinal infection cases due to LM in the literature, with 3 diagnosed as primary spondylodiscitis. RESULTS: The patient was treated with surgical decompression, debridement, and antibiotic therapy. Blood cultures remained negative throughout the case and microbiological cultures were obtained during surgery. The patient developed side-effects of prolonged gentamicin therapy but made a recovery from his spinal complaints at 6-months follow-up. Listeriosis is a relatively rare food-borne disease with a wide spectrum of presentation. Surgeons should consider more aggressive therapy for spinal infections and recognize the uncommon manifestations. We identified 3 primary and 2 secondary LM spondylodiscitis cases in the literature. Antibacterial treatment of LM spondylodiscitis varied in agents and duration, but no side-effects were previously reported. Gentamicin treatment requires care and attention to complications. DISCUSSION AND CONCLUSION: Listeria monocytogenes is a rare cause of primary spondylodiscitis. Further studies are needed to establish a safe treatment protocol for treatment with gentamicin and LM spondylodiscitis.