Discitis due to Clostridium perfringens - 19/04/08
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Abstract |
Introduction |
A combination of disk space narrowing and vacuum phenomenon on radiographs of the spine is usually considered a reliable indicator of degenerative disk disease. We report a case in which vacuum phenomenon was related to Clostridium perfringens discitis.
Methods |
A 79-year-old woman was admitted for inflammatory low back pain that had worsened steadily over the last 2 months. Her body temperature was normal, laboratory tests showed inflammation (erythrocyte sedimentation rate, 61mm/h; and C-reactive protein, 13mg/L), and blood cultures were negative. Imaging studies (radiographs, computed tomography [CT], and magnetic resonance imaging) indicated L4–L5 discitis. Vacuum phenomenon within the L4–L5 disk was seen on radiographs and CT scans. C. perfringens was recovered by fine-needle biopsy of the disk. Diverticular disease of the colon was the only identifiable portal of entry. Amoxicillin therapy ensured a full recovery.
Discussion |
C. perfringens discitis is rare, with only 7 published cases in humans. A gastrointestinal portal of entry was identified in 70% of cases. Radiographs or CT scans visualized vacuum phenomenon in 80% of cases. Positive blood cultures were noted in 75% of cases. The outcome was favorable with antibiotic therapy, even when a single-drug was used. The other characteristics of C. perfringens discitis were indistinguishable from those of discitis caused by the usual organisms.
Conclusion |
Presence of gas within the disk does not rule out infectious discitis and may indicate C. perfringens discitis.
Le texte complet de cet article est disponible en PDF.Keywords : Anaerobe, Clostridium perfringens, Discitis, Vacuum disk
Plan
Vol 75 - N° 2
P. 232-234 - mars 2008 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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