Spinal and paraspinal pneumococcal infections—a review

Spinal and paraspinal infections caused by Streptococcus pneumoniae remain a rare event. We present two cases from our institution, discuss the pathophysiology, and present a literature review of an additional 50 cases of spinal pneumococcal infections. Spinal epidural abscess and vertebral osteomye...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 2014-04, Vol.33 (4), p.517-527
Main Authors: Siddiq, D. M., Musher, D. M., Darouiche, R. O.
Format: Article
Language:English
Subjects:
Abscesses
Adolescent
Aged
Antimicrobial agents
Back pain
Bacterial diseases
Bacterial infections
Biological and medical sciences
Biomedical and Life Sciences
Biomedicine
Blood
Child
Child, Preschool
Edema
Epidural
Epidural Abscess - microbiology
Female
Human bacterial diseases
Humans
Infant
Infectious diseases
Internal Medicine
Literature reviews
Magnetic resonance imaging
Male
Medical Microbiology
Medical sciences
Middle Aged
Mortality
Osteomyelitis - microbiology
Patients
Pneumococcal Infections - microbiology
Review
Spinal cord
Spinal Diseases - microbiology
Spine
Staphylococcal infections, streptococcal infections, pneumococcal infections
Streptococcus infections
Streptococcus pneumoniae
Ultrasonic imaging
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Summary:Spinal and paraspinal infections caused by Streptococcus pneumoniae remain a rare event. We present two cases from our institution, discuss the pathophysiology, and present a literature review of an additional 50 cases of spinal pneumococcal infections. Spinal epidural abscess and vertebral osteomyelitis as well as paraspinal abscesses caused by pneumococcus were included in the analysis. As has been reported for spinal infections due to other bacteria, persistent localized back pain with an elevation in inflammatory markers was almost universal. The lumbar spine was the most commonly involved. Pneumococcus was most frequently isolated from material obtained at the site of the infection; blood cultures were a less common source. The majority of patients with neurologic deficits had spinal epidural abscess or phlegmon, and had a higher mortality. Most patients were treated with 6 weeks of parenteral antimicrobials, and surgical intervention was not associated with a mortality benefit.
ISSN:0934-9723
1435-4373
DOI:10.1007/s10096-013-1997-3