Top

European Spine Journal

Published in:

01-06-2012 | Case Report

Veillonella spondylodiscitis in a healthy 76-year-old lady

Authors: Thomas J. Kishen, Steven T. Lindstrom, Greg Etherington, Ashish D. Diwan

Published in: European Spine Journal | Special Issue 4/2012

Abstract

Purpose

To report a case of Veillonella spondylodiscitis in a healthy 76-year-old lady.

Methods

A previously healthy 76-year-old lady presented with worsening axial back pain at the thoracolumbar junction, fever and loss of weight. Examination revealed deep tenderness over the thoracolumbar junction with painful and restricted spinal movements. The lower limb motor power, sensation and reflexes were normal.

Results

Radiographs of the lumbosacral spine showed evidence of spinal instability with lateral translation and loss of disc space at L1–L2. MRI scans revealed fluid intensity within the L1–L2 disc with infective debris elevating the posterior longitudinal ligament and narrowing the spinal canal. Both tissue and blood cultures were positive for the anaerobic organism, Veillonella. A staged anterior-posterior spinal surgery followed by an extended course of antibiotics resulted in the clinical improvement and normalisation of blood parameters. A review of the literature on Veillonella infections is also presented.

Conclusion

The aim of this report is to bring Veillonella spondylodiscitis to the attention of spinal surgeons and infectious disease specialists and discuss the management options.

Chelsom J, Solberg CO (1998) Vertebral osteomyelitis at a Norwegian university hospital 1987–97: clinical features, laboratory findings and outcome. Scand J Infect Dis 30(2):147–151PubMedCrossRef

Beronius M, Bergman B, Andersson R (2001) Vertebral osteomyelitis in Goteborg, Sweden: a retrospective study of patients during 1990–95. Scand J Infect Dis 33(7):527–532PubMedCrossRef

Hadjipavlou AG, Mader JT, Necessary JT, Muffoletto AJ (2000) Hematogenous pyogenic spinal infections and their surgical management. Spine 25(13):1668–1679PubMedCrossRef

Carragee EJ (1997) Pyogenic vertebral osteomyelitis. J Bone Joint Surg Am 79(6):874–880PubMed

Kulowski J (1936) Pyogenic osteomyelitis of the spine. An analysis and discussion of 102 cases. J Bone Joint Surg Am 18:343–364

Chen WH, Jiang LS, Dai LY (2007) Surgical treatment of pyogenic vertebral osteomyelitis with spinal instrumentation. Eur Spine J 16(9):1307–1316PubMedCrossRef

Garcia A Jr, Grantham SA (1960) Hematogenous pyogenic vertebral osteomyelitis. J Bone Joint Surg Am A 42:429–436

Rezai AR, Woo HH, Errico TJ, Cooper PR (1999) Contemporary management of spinal osteomyelitis. Neurosurgery 44(5):1018–1025 (discussion 1025–1026)PubMedCrossRef

Butler E, Blusger I, Perry K (1941) Staphylococcal osteomyelitis of the spine. Lancet 480–481

10.

Hall BB, Fitzgerald RH Jr, Rosenblatt JE (1983) Anaerobic osteomyelitis. J Bone Joint Surg Am 65(1):30–35PubMed

11.

Rovery C, Etienne A, Foucault C, Berger P, Brouqui P (2005) Veillonella montpellierensis endocarditis. Emerg Infect Dis 11(7):1112–1114PubMedCrossRef

12.

Zaninetti-Schaerer A, Van Delden C, Genevay S, Gabay C (2004) Total hip prosthetic joint infection due to Veillonella species. Joint Bone Spine 71(2):161–163PubMedCrossRef

13.

Marchandin H, Jean-Pierre H, Carriere C, Canovas F, Darbas H, Jumas-Bilak E (2001) Prosthetic joint infection due to Veillonella dispar. Eur J Clin Microbiol Infect Dis 20(5):340–342PubMedCrossRef

14.

Liu JW, Wu JJ, Wang LR, Teng LJ, Huang TC (1998) Two fatal cases of Veillonella bacteremia. Eur J Clin Microbiol Infect Dis 17(1):62–64PubMedCrossRef

15.

Sato T, Matsuyama J, Sato M, Hoshino E (1997) Differentiation of Veillonella atypica, Veillonella dispar and Veillonella parvula using restricted fragment-length polymorphism analysis of 16S rDNA amplified by polymerase chain reaction. Oral Microbiol Immunol 12(6):350–353PubMedCrossRef

16.

Sutter VL, Finegold SM (1976) Susceptibility of anaerobic bacteria to 23 antimicrobial agents. Antimicrob Agents Chemother 10(4):736–752PubMed

17.

Nyfors S, Kononen E, Bryk A, Syrjanen R, Jousimies-Somer H (2003) Age-related frequency of penicillin resistance of oral Veillonella. Diagn Microbiol Infect Dis 46(4):279–283PubMedCrossRef

18.

Marriott D, Stark D, Harkness J (2007) Veillonella parvula discitis and secondary bacteremia: a rare infection complicating endoscopy and colonoscopy? J Clin Microbiol 45(2):672–674PubMedCrossRef

19.

Isner-Horobeti ME, Lecocq J, Dupeyron A, De Martino SJ, Froehlig P, Vautravers P (2006) Veillonella discitis. A case report. Joint Bone Spine 73(1):113–115PubMedCrossRef

20.

Barnhart RA, Weitekamp MR, Aber RC (1983) Osteomyelitis caused by Veillonella. Am J Med 74(5):902–904PubMedCrossRef

21.

Bongaerts GP, Schreurs BW, Lunel FV, Lemmens JA, Pruszczynski M, Merkx MA (2004) Was isolation of Veillonella from spinal osteomyelitis possible due to poor tissue perfusion? Med Hypotheses 63(4):659–661PubMedCrossRef

Title: Veillonella spondylodiscitis in a healthy 76-year-old lady
Authors: Thomas J. Kishen
Steven T. Lindstrom
Greg Etherington
Ashish D. Diwan
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue Special Issue 4/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-011-1871-x

At a glance: The STEP trials

Springer Medicine

Veillonella spondylodiscitis in a healthy 76-year-old lady

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Special Issue 4/2012

Minimally invasive lumbopelvic instrumentation for traumatic sacrolisthesis in an elderly patient

Chronic dura erosion and intradural lumbar disc herniation: CT and MR imaging and intraoperative photographs of a transdural sequestrectomy

Rapid progression of spinal epidural lipomatosis

CT-guided percutaneous translaminar approach for blood patching: case report and technical note

Bilateral vasculopexy of anomalous vertebral arteries causing cervicomedullary compression: case report and technical note

C2 lamina reconstruction using locking miniplate for the intradural tumor of the craniocervical junction (two case reports)