Vertebral osteomyelitis in a healthy young adult. WMJ 2007 May;106(3):152-4
Date
07/24/2007Pubmed ID
17642354Scopus ID
2-s2.0-34249996754 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
A 39-year-old African American man with no significant past medical history presented to our hospital with right hand weakness and pain in both arms. He had no fever, neck pain, headache, dizziness, vision changes, or weakness in his lower extremities. Magnetic resonance imaging of the cervical spine showed extensive abnormal enhancement of the C7-T1 vertebral bodies as well as the prevertebral and epidural spaces. Open biopsy of the lesion showed inflammatory changes consistent with osteomyelitis. Culture of the biopsy specimen grew Group B Streptococcus (GBS). HIV ELISA and blood cultures were negative. The patient was treated with intravenous vancomycin for 6 weeks with complete resolution of symptoms. GBS classically affects newborns and pregnant females. However, the incidence of infection from this pathogen in nonpregnant adults is increasing. Vertebral osteomyelitis due to GBS in nonpregnant adults is exceedingly rare. To our knowledge, this is the first reported case of GBS cervical vertebral osteomyelitis in an adult without risk factors for invasive GBS infection. This case illustrates that GBS should be included in the differential diagnosis of pyogenic vertebral osteomyelitis, irrespective of immune status and predisposing factors.
Author List
Jain N, Patel D, Pfeifer KJAuthor
Kurt J. Pfeifer MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAnti-Infective Agents
Biopsy
Combined Modality Therapy
Diagnosis, Differential
Drainage
Humans
Magnetic Resonance Imaging
Male
Osteomyelitis
Spinal Diseases
Streptococcal Infections
