Case report: First reported case of spondylodiscitis caused by Gemella morbillorum in South Africa
DOI:
https://doi.org/10.7196/SAMJ.2024.v114i11.3449Keywords:
verterbral osteomyelitis, discitis, Gemella morbillorum, spondylodiscitisAbstract
Pyogenic spondylodiscitis is an uncommon but important clinical condition that often requires medical and/or surgical management. We report a case of spondylodiscitis caused by a rare pathogen, Gemella morbillorum. To date, worldwide, only six such cases of confirmed spondylodiscitis infection with this rare pathogen have been documented, and this is the first reported case in South Africa. The patient was a 55-year-old female who presented to us with a 1-month history of severe back pain radiating to her left leg. She reported to us that she visited the dentist around the time of onset of the symptoms. A workup showed raised inflammatory markers, and a positron emission tomography scan indicated features of discitis at level L2/L3. Tissue cultures from a biopsy identified G. morbillorum species infection, and she was treated successfully with antibiotics for 6 weeks. It is important to have a high index of suspicion when a patient has a history of dental work, and to rule out associated infection such as endocarditis. Treatment with culture-driven antibiotics yields good results.
References
1. Cheung WY, Luk KD. Pyogenic spondylitis. Int Orthop 2012;36(2):397-404. https://doi.org/10.1007/ s00264-011-1384-6
2. Skaf GS, Domloj NT, Fehlings MG, et al. Pyogenic spondylodiscitis: An overview. J Infect Public Health 2010;3(1):5-16. https://doi.org/10.1016/j.jiph.2010.01.001
3. Sono T, Takemoto M, Shinohara K, Tsuchido Y. An uncommon case of pyogenic spondylodiscitis caused by Gemella morbillorum. Case Rep Orthop 2018;2018:3127613. https://doi.org/10.1155/2018/3127613
4. Saad E, Faris ME, Abdalla MS, Prasai P, Ali E, Stake J. A rare pathogen of bones and joints: A systematic review of osteoarticular infections caused by Gemella morbillorum. J Clin Med Res 2023;15(4):187-
199. https://doi.org/10.14740/jocmr4891
5. Selçuk N, Esma C, Ahmet Rıza Ş, Selma A. Evaluation of cases with Gemella infection: Cross-sectional
study. J Infect Dis Epidemiol 2018;4(4):063 https://doi.org/10.23937/2474-3658/1510063
6. BenedettiP,RassuM,BranscombeM,SeftonA,PellizzerG.Gemellamorbillorum:Anunderestimated aetiology of central nervous system infection? J Med Microbiol 2009;58(Pt 12):1652-1656. https://
doi.org/10.1099/jmm.0.013367-0
7. Hsu CY, Su YC, Wang TL, Chong CF, Chen CC. Gemella morbillorum liver abscess. Scand J Infect Dis 2007;39(6-7):637-638. https://doi.org/10.1080/00365540601169737
8. Pardo-Pol A, Perez-Prieto D, Alier A, et al. Acute hematogenous periprosthetic hip infection by Gemella morbillorum, successfully treated with debridement, antibiotics and implant retention: A case report and literature review of osteoarticular Gemella morbillorum infections. Trop Med Infect Dis 2022;7(8):191 https://doi.org/10.3390/tropicalmed7080191
9. Withanage ND, Athiththan LV, Perera S, Pathirage S, Peiris H. Isolation of Gemella morbillorum in herniated intervertebral disc tissue in a lumbar discectomy patient: A case report. J Biosciences Med 2017;05(03):99-104. https://doi.org/10.4236/jbm.2017.53010
10. Krogsgaard MR, Wagn P, Bengtsson J. Epidemiology of acute vertebral osteomyelitis in Denmark: 137 cases in Denmark 1978 - 1982, compared to cases reported to the National Patient Register 1991 - 1993. Acta Orthop Scand 1998;69(5):513-517. https://doi.org/10.3109/17453679808997789
11. Rezai AR, Woo HH, Errico TJ, Cooper PR. Contemporary management of spinal osteomyelitis. Neurosurgery 1999;44(5):1018-1025. https://doi.org/10.1097/00006123-199905000-00047
12. Weinstein MA, Eismont FJ. Infections of the spine in patients with human immunodeficiency virus. J Bone Joint Surg Am 2005;87(3):604-609. https://doi.org/10.2106/jbjs.c.01062
13. Friedman JA, Maher CO, Quast LM, McClelland RL, Ebersold MJ. Spontaneous disc space infections in adults. Surg Neurol 2002;57(2):81-86. https://doi.org/10.1016/S0090-3019(01)00681-4
14. Lee JH, Kim J, Kim TH. Clinical outcomes in older patients aged over 75 years who underwent early surgical treatment for pyogenic vertebral osteomyelitis. J Clin Med 2021;10(22):5451. https://doi. org/10.3390/jcm10225451
15. Herren C, Jung N, Pishnamaz M, Breuninger M, Siewe J, Sobottke R. Spondylodiscitis: Diagnosis and treatment options. Dtsch Arztebl Int 2017;114(51-52):875-882. https://doi.org/10.3238/arztebl.2017.0875 16. Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: Update on diagnosis and management.
J Antimicrob Chemother 2010;65(Suppl 3):iii11-24. https://doi.org/10.1093/jac/dkq303
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Licensing Information
The SAMJ is published under an Attribution-Non Commercial International Creative Commons Attribution (CC-BY-NC 4.0) License. Under this license, authors agree to make articles available to users, without permission or fees, for any lawful, non-commercial purpose. Users may read, copy, or re-use published content as long as the author and original place of publication are properly cited.
Exceptions to this license model is allowed for UKRI and research funded by organisations requiring that research be published open-access without embargo, under a CC-BY licence. As per the journals archiving policy, authors are permitted to self-archive the author-accepted manuscript (AAM) in a repository.
Publishing Rights
Authors grant the Publisher the exclusive right to publish, display, reproduce and/or distribute the Work in print and electronic format and in any medium known or hereafter developed, including for commercial use. The Author also agrees that the Publisher may retain in print or electronic format more than one copy of the Work for the purpose of preservation, security and back-up.
