cefotaxime and Discitis

Campylobacter coli is a rare cause of bacteremia. We report here the first case of C.coli spondylodiscitis complicated by an aortic aneurysm. Outcome was favourable with surgery and antibiotic therapy.

Topics: Aged; Anti-Bacterial Agents; Aortic Aneurysm, Abdominal; Bacteremia; Campylobacter coli; Campylobacter Infections; Cefotaxime; Ciprofloxacin; Discitis; Drug Therapy, Combination; Gentamicins; Humans; Male; Radiography

We report on a 54-year-old man with chronic lower back pain after recent streptococcus pneumoniae pulmonary infection, resulting in a mycotic aortic aneurysm and spondylodiscitis of the eighth vertebrae 6 months later. Successful surgical treatment and recurrence-free survival after 4 years are described.. Osteomyelitis by Streptococcus pneumoniae of the spine combined with contained rupture of a mycotic aortic aneurysm into lung and spine has not been reported to date. Mycotic aneurysms with pulmonary fistulas are reported to carry a mortality rate of up to 100%. Few cases have been reported with different operative and conservative strategies.. The mycotic aortic aneurysm was excised using extracorporeal circulation and replaced by a Dacron graft. The spondylitic section of the eighth thoracic vertebrae was radically resected, and a tricortical bone block from the iliac crest was inserted into the defect. To keep compartments separated, collagen sponges with antibiotic supplementation were used. A triple antibiotic therapy (Metronidazol 3 x 0.5 g/day, Cefotaxim 3 x 2 g/day, and Flucloxacillin 3 x 2 g/day) was prescribed for 6 weeks and changed to Clindamycin for 1 year thereafter.. The patient made a good recovery and is free of recurrence 4 years after surgery.. Lower back pain might be a projected pain. Particularly in older patients or in the presence of comorbidities resulting in an immunocompromised status, an aggressive workup may be indicated. Radical resection of inflammatory tissues, sparse use of implant material, and prolonged administration of antibiotics proved a successful strategy in this patient.

Topics: Aneurysm, Infected; Anti-Bacterial Agents; Aortic Aneurysm, Thoracic; Blood Vessel Prosthesis Implantation; Cefotaxime; Combined Modality Therapy; Discitis; Fistula; Floxacillin; Humans; Ischemia; Lung Diseases; Male; Metronidazole; Middle Aged; Nervous System Diseases; Osteomyelitis; Pneumococcal Infections; Pneumonia, Pneumococcal; Postoperative Complications; Respiratory Tract Fistula; Spinal Cord; Spinal Diseases; Spondylitis; Streptococcus pneumoniae; Thoracic Vertebrae; Tomography, X-Ray Computed; Tracheal Diseases; Treatment Outcome

Topics: Aged; Bacteremia; Cefotaxime; Citrobacter; Discitis; Drug Therapy, Combination; Electrodes, Implanted; Endocarditis, Bacterial; Enterobacteriaceae Infections; Equipment Contamination; Humans; Imipenem; Lumbar Vertebrae; Male; Pacemaker, Artificial; Sacrum; Tobramycin

Topics: Cefotaxime; Child, Preschool; Discitis; Drug Therapy, Combination; Floxacillin; Humans; Low Back Pain; Lumbar Vertebrae; Male; Pain Measurement; Treatment Outcome

Discitis is an inflammatory disease of the intervertebral disc which has usually a benign evolution in childhood. It often recognizes an infectious etiology. Still discussed however is the possibility of a primitive discal involvement (not secondary to a vertebral inflammation) or of a non infectious etiology and the subsequent more correct diagnostic-therapeutic procedures. We report a case of a girl with discitis diagnosed early and treated with antibiotics and orthopedic corset, whose follow-up shows a benign evolution. We underline the importance of modern neuroradiological imaging: in particular, MR plays a major role in the inflammatory diseases of the column, both in diagnosis and in follow-up. MR scans of the involved disc allow frequent controls without radiogenic risks and with a good resolution because of the multiplanarity typical of the method.

Topics: Anti-Infective Agents; Cefotaxime; Cephalosporins; Child; Ciprofloxacin; Discitis; Female; Humans; Lumbosacral Region; Magnetic Resonance Imaging; Teicoplanin

Topics: Aged; Cefixime; Cefotaxime; Discitis; Enterobacter; Enterobacteriaceae Infections; Humans; Male