Document Detail

Spinal abscess and spondylitis due to actinomycosis.
MedLine Citation:
PMID:  9516706     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: Report of a rare case of spinal actinomycosis in a young immunocompetent woman. OBJECTIVE: To show the difficulties in diagnosing spinal actinomycosis. SUMMARY OF BACKGROUND DATA: Spinal actinomycosis is rare and usually occurs as a result of a contiguous (abdominal, pelvic, or thoracic) spread of the infection. This localization represents less than 5% of the infectious sites and was mainly, before the penicillin era, a postmortem discovery. METHODS: A case is reported of a 34-year-old Algerian woman who had fever, persistent cough, right-side thoracic pain, and progressive severe back pain. Radiographs, computed tomographic scan, and magnetic resonance imaging demonstrated lytic areas on the vertebral bodies of T11 and T12 and a paravertebral mass, without disk involvement. A surgical biopsy of T12 and the paravertebral abscess was performed. RESULTS: Presence of characteristic sulfur granules and gram-positive filamentous bacteria in surgical biopsy tissues and isolation of Actinobacillus actinomycetemcomitans in cultures led to the diagnosis of vertebral actinomycosis. The patient was virtually free of pain and fever after a 3-month regimen of ofloxacin and rifampicin (Rifadine, Marion-Merell, France) and was without recurrence after 18 months of follow-up. CONCLUSIONS: Actinomycosis of the spine, caused by the spread of a paraspinal abscess, is extremely rare. The previously poor prognosis has been transformed by antibiotics.
L Voisin; O Vittecoq; O Mejjad; C Krzanowska; T Defives; C Cambon-Michot; X Le Loët
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Spine     Volume:  23     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-05-08     Completed Date:  1998-05-08     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:  487-90     Citation Subset:  IM    
Department of Rheumatology, Rouen University Hospital, France.
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MeSH Terms
Abscess / diagnosis,  drug therapy,  microbiology*
Actinomycosis / complications*,  diagnosis,  drug therapy
Anti-Infective Agents / therapeutic use
Drug Combinations
Magnetic Resonance Imaging
Ofloxacin / therapeutic use
Rifampin / therapeutic use
Spinal Diseases / diagnosis,  drug therapy,  microbiology*
Spine / pathology
Spondylitis / diagnosis,  drug therapy,  microbiology*
Reg. No./Substance:
0/Anti-Infective Agents; 0/Drug Combinations; 13292-46-1/Rifampin; 82419-36-1/Ofloxacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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