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Case Reports
. 2022 Jun 29;14(6):e26413.
doi: 10.7759/cureus.26413. eCollection 2022 Jun.

First Case of Pyogenic Spondylodiscitis Caused by Gemella sanguinis

Kunihiko Hashimoto  1   2 , Eiji Wada  1   2 , Kazuma Kitaguchi  1   2 , Kazuya Ooshima  2 , Kenji Hayashida  1
Affiliations
Case Reports

First Case of Pyogenic Spondylodiscitis Caused by Gemella sanguinis

Kunihiko Hashimoto et al. Cureus. .

Abstract

A 78-year-old man presented with back pain. Magnetic resonance imaging revealed marrow edema within the L4 and L5 vertebral bodies and a spinal epidural abscess in the spinal canal. The patient was considered to have pyogenic spondylodiscitis at the L4/L5 level. The Gram-positive cocci isolated from blood cultures were subsequently identified as Gemella sanguinis using matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS). Symptom improvement was achieved and the infection was eradicated with conservative treatment (treatment with ceftriaxone [CTRX] and minocycline [MINO]). We report the first case of G. sanguinis-associated pyogenic spondylodiscitis. MALDI-TOF MS was useful in identifying this uncommon bacterium.

Keywords: gemella sanguinis; infection; maldi-tof ms; orthopedic disease; pyogenic spondylodiscitis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Radiography image of the lumbar spine.
The image shows the presence of spondylosis but no signs of radiolucent shadows or fractures.
Figure 2
Figure 2. Computed tomography image of the lumbar spine.
The image shows destruction of the vertebral body and pedicle (arrows) centered on end plates on the right side of L5.
Figure 3
Figure 3. Magnetic resonance image of the lumbar spine.
The image shows marrow edema (arrows) within the L4 and L5 vertebral bodies and spinal epidural abscess (white arrowhead) on the short-Ti inversion recovery image (a). Spinal epidural abscess (white arrowhead) in the spinal canal at the level of L5 on the T2-weighted image (b).
Figure 4
Figure 4. Colonies of Gemella sanguinis on a sheep blood agar plate after incubation for 24 hours at 35 °C (a). Colonies of Gemella sanguinis on a chocolate agar plate after incubation for 24 hours at 37 °C (b).
Figure 5
Figure 5. Medical treatment process and laboratory data.
WBC: white blood cell count; CRP: C-reactive protein level.
Figure 6
Figure 6. Computed tomography image of the lumbar spine at one-year follow-up.
The image shows remodeling of the vertebral body and pedicle (arrows) on the right side of L5.
See this image and copyright information in PMC

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