Bacteroides fragilis spondylitis after suspected oral ulcer: a clinical case and comprehensive literature review

• Published in: Anaerobe 2024-08, Vol.88, p.102863, Article 102863
• Main Authors: Chen, Long, Zhang, Tao, Wang, Yizhe, Lu, Yanpeng, Chen, Xingyu, Tan, Xingguo, Huang, Dashuai, Li, Songkai
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Bacteroides fragilis; Bacteroides fragilis - genetics; Bacteroides fragilis - isolation & purification; Bacteroides Infections - diagnosis; Bacteroides Infections - drug therapy; Bacteroides Infections - microbiology; Diagnistic metagenomic sequencing; Female; Humans; Male; Middle Aged; Oral Ulcer - diagnosis; Oral Ulcer - microbiology; Pyogenic spondylitis; Spondylitis - diagnosis; Spondylitis - microbiology
• ISSN: 1075-9964; 1095-8274; 1095-8274
• DOI: 10.1016/j.anaerobe.2024.102863

This paper reports a case of Bacteroides fragilis induced spondylitis. Diagnosis was confirmed through blood culture and metagenomic sequencing of pus for pathogen detection. Due to persistent lumbar pain, surgical intervention became imperative, resulting in favorable postoperative outcomes. A detailed patient history revealed a severe episode of oral ulceration two weeks before symptom onset, although a direct link to the infection remained elusive. Leveraging insights from this case, we conducted a comprehensive literature review on B. fragilis spondylitis, elucidating clinical manifestations, diagnostic methodologies, and therapeutic strategies. •Rare spondylitis caused by B. fragilis.•The likely source of infection was an oral ulcer.•Most of the infections come from the digestive tract and urogenital tract.•Drug therapy was ineffective for 4 weeks, and surgical intervention was performed.•Pathogen metagenomic sequencing facilitates early auxiliary diagnosis.