First case of multiple discitis and sacroiliitis due to Abiotrophia defectiva

Abstract

The case reported here is, to the best of our knowledge, the first of probable endocarditis revealed by sacroiliitis and multiple discitis due to Abiotrophia defectiva. This organism was formerly included with Granulicatella in the group of “satellite” streptococci because of its growth pattern as satellite colonies in the vicinity of unrelated bacteria and in the group of “nutritionally variant streptococci” (NVS) because of its fastidious growth in vitro [1, 2]. It is a member of the normal flora of the human oropharyngeal, urogenital and intestinal tracts and an infrequent cause of endocarditis [3, 4]. To our knowledge, only five cases of osteoarticular infections due to NVS have been reported to date, including one case of culture-negative arthritis (with endocarditis) [1], one case of osteomyelitis (secondary to a pacemaker infection) [5] and two cases of vertebral osteomyelitis and discitis (secondary to endocarditis) [6], all due to G. adiacens, and only one knee arthroplasty infection due to A. defectiva [7]. A 51-year-old male was admitted to our hospital for treatment of acute back pain without fever associated with sciatica. He had suffered from stable grade III mitral valvulopathy for 10 years. During the 6 weeks before admission he