Spondylodiszitis durch Peptostreptococcus micros

Abstract

Summary Spondylodiscitis due to Peptostreptococcus micros We report the case of a 58-year-old female patient with lumbar vertebral osteomyelitis and discitis due to Peptostreptococcus micros. Initially the patient’s spontaneous lower back pain had been regarded as due to degenerative osteochondrosis. She was admitted to the hospital for evaluation of progressively worsening pain and suspicion of spondylodiscitis. CT-guided aspiration of the disc space yielded gram-positive cocci in the Gram stain, which did not grow on culture but were identified as P. micros by molecular methods (PCR and DNA sequencing). The patient received intravenous amoxicillin/clavulanic acid for 4 weeks plus oral clindamycin for 9 weeks. The back pain resolved within weeks and follow-up showed complete resolution of the infection. Paraspinal abscesses or discitis caused by P. micros have rarely been reported. Since our patient had undergone an invasive oral procedure some weeks before the onset of lower back pain, we suspect an oral source as the origin of the infection, with subsequent hematogenous seeding.