Streptococcus intermedius spondylodiskitis

We report a case of spondylodiskitis caused by Streptococcus intermedius. A 48-year-old man presented with a three-day history of back pain of gradual onset accompanied by remittent fever of up to 39.8 degree C. Spinal MRI showed narrowing of the T12-L1 space with projection of the disk, inflammator...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 1994-09, Vol.13 (9), p.776-777
Main Authors: Georgilis, K, Prifti, H, Vorropoulou, O, Petrocheilou-Paschou, V
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents
Discitis - diagnosis
Discitis - drug therapy
Discitis - microbiology
Drug Therapy, Combination - therapeutic use
Humans
Male
Middle Aged
Streptococcal Infections - diagnosis
Streptococcal Infections - drug therapy
Streptococcal Infections - microbiology
Streptococcus - classification
Streptococcus intermedius
Thoracic Vertebrae
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Summary:We report a case of spondylodiskitis caused by Streptococcus intermedius. A 48-year-old man presented with a three-day history of back pain of gradual onset accompanied by remittent fever of up to 39.8 degree C. Spinal MRI showed narrowing of the T12-L1 space with projection of the disk, inflammatory lesions of the disk and of T12 and L1 adjacent to the disk, and multiple degenerative lesions with osteophytes along the spine. Subsequently, the streptococcus isolated was identified as a Streptococcus milleri group organism and the same organism was grown in five more sets of blood cultures (total of six sets), being further typed as Streptococcus intermedius. The patient was started on intravenous penicillin and gentamicin to treat the bacteremia and presumed diskitis. We decided to treat him with intravenous antibiotics for at least six weeks, as if he had osteomyelitis. After three weeks of penicillin and gentamicin the treatment was changed to intravenous ceftriaxone (2 g every 24 h), which he received as an outpatient for four weeks (until his ESR returned to normal). He then received ciprofloxacin per os for two months. He is now in excellent health six months after his initial presentation.
ISSN:0934-9723
1435-4373
DOI:10.1007/BF02276068