Document Detail


Nocardia farcinica spinal osteomyelitis.
MedLine Citation:
PMID:  12004185     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: A case of disseminated Nocardia farcinica infection with spine involvement is reported. OBJECTIVE: To describe the first case of Nocardia farcinica spinal osteomyelitis, and to propose spine instrumentation with debridement and multiple antibiotics for treatment of nocardia spinal osteomyelitis. SUMMARY OF BACKGROUND DATA: Only 11 cases involving Nocardia asteroides spinal osteomyelitis have been reported over the past 40 years. These case reports describe various presentations and treatments of nocardia spinal osteomyelitis. METHODS: A 54-year-old nonambulant, paraparetic man was admitted to the authors' hospital with acutely increased low back pain, fever, and signs of dementia. A disseminated Nocardia farcinica infection including spinal osteomyelitis at T11, T12, L1, L2, and L4; epidural abscess T10-L4, L5-S1 discitis, empyemas, cerebral abscess, and bilateral psoas abscess was noted. RESULTS: Antibiotic therapy, multiple debridements, and posterior instrumentation were performed to palliate the Nocardia farcinica infection. At a recent 3-year follow-up assessment, the patient was independent and ambulant. He had been off antibiotics for 5 months. CONCLUSIONS: Previous case reports of nocardia spinal osteomyelitis describe treatment with antibiotics, debridements, and arthrodesis with autologous bone graft. Prolonged recumbency ensued. In the reported case, a combination of antibiotics, debridements, arthrodesis, and posterior instrumentation for immediate stabilization of the spine resulted in a favorable outcome at 3 years.
Authors:
Harm C A Graat; André Van Ooij; Gregory A Day; I Bruce McPhee
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Spine     Volume:  27     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-10     Completed Date:  2002-05-28     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E253-7     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, University Hospital Maastricht, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Epidural Abscess / microbiology,  surgery
Humans
Male
Middle Aged
Nocardia / isolation & purification
Nocardia Infections / microbiology*,  pathology
Osteomyelitis / microbiology*,  pathology,  surgery
Spinal Diseases / microbiology*,  pathology,  surgery

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