Spondylodiscitis of lumbar complicated with spinal epidural abscess caused by Parvimonas micra: A case report and literature review. 2023

Yan Yang, and Jianhuang Wu, and Jianzhong Hu, and Tianding Wu
Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008. 1984575043@qq.com.

Spinal infection caused by Parvimonas micra (P. micra) is a rare infection. The characteristic imageology includes spondylodiscitis, spondylitis, paravertebral abscess, and epidural abscess. One case of spondylodiscitis of lumbar complicated with spinal epidural abscess caused by P. micra was admitted to the Department of Spinal Surgery, Xiangya Hospital, Central South University on February, 2023. This case is a 60 years old man with lower back pain and left lower limb numbness. MRI showed spondylitis, spondylodiscitis, and epidural abscess. The patient underwent debridement, decompression and fusion surgery. The culture of surgical sample was negative. P. micra was detected by metagenomic next-generation sequencing (mNGS). The postoperative antibiotic treatment included intravenous infusion of linezolid and piperacillin for 1 week, then intravenous infusion of ceftazidime and oral metronidazole for 2 weeks, followed by oral metronidazole and nerofloxacin for 2 weeks. During the follow-up, the lower back pain and left lower limb numbness was complete remission. Spinal infection caused by P. micra is extremely rare, when the culture is negative, mNGS can help the final diagnosis.

UI MeSH Term Description Entries
D006987 Hypesthesia Absent or reduced sensitivity to cutaneous stimulation. Hypesthesia, Tactile,Hypesthesia, Thermal,Hypoesthesia,Numbness,Impaired Sensation,Reduced Sensation,Hypesthesias,Hypesthesias, Tactile,Hypesthesias, Thermal,Hypoesthesias,Impaired Sensations,Reduced Sensations,Sensation, Impaired,Sensation, Reduced,Sensations, Impaired,Sensations, Reduced,Tactile Hypesthesia,Tactile Hypesthesias,Thermal Hypesthesia,Thermal Hypesthesias
D008297 Male Males
D008795 Metronidazole A nitroimidazole used to treat AMEBIASIS; VAGINITIS; TRICHOMONAS INFECTIONS; GIARDIASIS; ANAEROBIC BACTERIA; and TREPONEMAL INFECTIONS. 2-Methyl-5-nitroimidazole-1-ethanol,Bayer 5360,Clont,Danizol,Flagyl,Gineflavir,Metric,MetroGel,Metrodzhil,Metrogyl,Metronidazole Hydrochloride,Metronidazole Monohydrochloride,Metronidazole Phosphate,Metronidazole Phosphoester,Satric,Trichazol,Trichopol,Trivazol,Vagilen,2 Methyl 5 nitroimidazole 1 ethanol
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000068536 Firmicutes A phylum of predominantly GRAM-POSITIVE BACTERIA that includes the orders Bacillales and Clostridiales. Firmicutes and BACTEROIDETES are the two bacterial phyla that constitute the majority of the human gut MICROBIOTA.
D013166 Spondylitis Inflammation of the SPINE. This includes both arthritic and non-arthritic conditions. Spondylitides
D015299 Discitis Inflammation of an INTERVERTEBRAL DISC or disk space which may lead to disk erosion. Until recently, discitis has been defined as a nonbacterial inflammation and has been attributed to aseptic processes (e.g., chemical reaction to an injected substance). However, recent studies provide evidence that infection may be the initial cause, but perhaps not the promoter, of most cases of discitis. Discitis has been diagnosed in patients following discography, myelography, lumbar puncture, paravertebral injection, and obstetrical epidural anesthesia. Discitis following chemonucleolysis (especially with chymopapain) is attributed to chemical reaction by some and to introduction of microorganisms by others. Spondylodiscitis,Diskitis,Spondylodiskitis,Discitides,Diskitides,Spondylodiscitides,Spondylodiskitides
D017116 Low Back Pain Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous SPRAINS AND STRAINS; INTERVERTEBRAL DISK DISPLACEMENT; and other conditions. Lumbago,Low Back Ache,Low Back Pain, Mechanical,Low Back Pain, Posterior Compartment,Low Back Pain, Postural,Low Back Pain, Recurrent,Low Backache,Lower Back Pain,Mechanical Low Back Pain,Postural Low Back Pain,Recurrent Low Back Pain,Ache, Low Back,Aches, Low Back,Back Ache, Low,Back Aches, Low,Back Pain, Low,Back Pain, Lower,Back Pains, Low,Back Pains, Lower,Backache, Low,Backaches, Low,Low Back Aches,Low Back Pains,Low Backaches,Lower Back Pains,Pain, Low Back,Pain, Lower Back,Pains, Low Back,Pains, Lower Back
D020802 Epidural Abscess Circumscribed collections of suppurative material occurring in the spinal or intracranial EPIDURAL SPACE. The majority of epidural abscesses occur in the spinal canal and are associated with OSTEOMYELITIS of a vertebral body; ANALGESIA, EPIDURAL; and other conditions. Clinical manifestations include local and radicular pain, weakness, sensory loss, URINARY INCONTINENCE, and FECAL INCONTINENCE. Cranial epidural abscesses are usually associated with OSTEOMYELITIS of a cranial bone, SINUSITIS, or OTITIS MEDIA. (From Adams et al., Principles of Neurology, 6th ed, p710 and pp1240-1; J Neurol Neurosurg Psychiatry 1998 Aug;65(2):209-12) Abscess, Epidural,Abscess, Extradural,Spinal Epidural Abscess,Cranial Epidural Abscess,Cranial Extradural Abscess,Epidural Abscess, Intracranial,Epidural Abscess, Spinal,Intracranial Extradural Abscess,Spinal Extradural Abscess,Abscess, Cranial Epidural,Abscess, Cranial Extradural,Abscess, Intracranial Epidural,Abscess, Intracranial Extradural,Abscess, Spinal Epidural,Abscess, Spinal Extradural,Abscesses, Intracranial Extradural,Epidural Abscess, Cranial,Extradural Abscess,Extradural Abscess, Intracranial,Extradural Abscess, Spinal,Extradural Abscesses, Intracranial,Intracranial Epidural Abscess,Intracranial Extradural Abscesses

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