Spondylodiscitis and epidural abscess due to Chryseobacterium indologene

Abstract

Introduction: Spondylodiscitis is the infection of the vertebral plates, which can extend to the intervertebral disc and generate an epidural abscess. More frequent in the lumbar spine, then dorsal and finally cervical. From 2 to 7% of bone infections, mortality rate from 1 to 20%. Hematogenous spread (common). The most common germ is Staphylococcus aureus, followed by Streptococcus, Mycobacterium tuberculosis, and Enterobacteriaceae. Chryseobacteria are aerobic gram-negative rods Chryseobacterium indologenes is the most frequent, common in immunocompromised patients.
Clinical case: 55-year-old male with a history of lumbar surgery in 2014, due to degenerative pathology. He presented a surgical site infection and a surgical toilet was performed, without obtaining germ, empirical antibiotic treatment (ciprofloxacin and TMS). Years later he presented progressive lumbar and radicular pain. Loosening of the radiological implant, and spondylodiscitis in MRI. Biopsy under CT, Staphylococcus epidermidis, sensitivity (ciprofloxacin and rifampicin). Abscess is drained and prosthesis removed. Positive cultures for C. indologenes, susceptibility (levofloxacin and rifampicin).
Conclusion: Epidural abscess is a rare but potentially devastating condition. Treatment is determined by the neurological status and condition of the patient.