Spondylodiscitis due to Haemophilus parainfluenzae: A Case Report

Abstract

Introduction Haemophilus parainfluenzae (HP) is a gram-negative coccobacillus and an opportunistic pathogen. It is rarely associated with spinal- and musculoskeletal-site infections, and very little reported in the literature.

Case Presentation An otherwise healthy, 45-year-old woman who presented with a two-week history of progressive low back pain, fever, coryza and nasal congestion, was found to have intervertebral discitis caused by HP, confirmed by two positive blood cultures and progressive lumbar spine magnetic resonance imaging (MRI) findings. The MRI findings were atypical, consisting of a psoas abscess and small anterior epidural and intraspinal fluid collections associated with spondylodiscitis. The initial diagnosis was delayed because the initial MRI failed to reveal findings suggestive of an infectious process. The treatment consisted of a long course of intravenous followed by oral antibiotics, ultimately yielding a good clinical response.

Discussion and Conclusion Haemophilus parainfluenzae is a very rare pathogen in spondylodiscitis. Nonetheless, it should be considered, especially in patients presenting with low back pain and fever and/or gram bacteremia. The initial work-up should include contrast-enhanced MRI of the spine. Although rare, spondylodiscitis and a psoas abscess can present concomitantly. Prolonged antibiotics are the mainstay of treatment.

Keywords

Haemophilus parainfluenzae - low back pain - spondylodiscitis - magnetic resonance imaging - psoas abscess

Publikationsverlauf

Eingereicht: 20. September 2020

Angenommen: 18. Mai 2022

Artikel online veröffentlicht:
03. Oktober 2022

• Referencias

• 1 Kohr BS, Liaw SJ, Liao HC, Yang CC, Lee MH. Bone and Joint Infections Caused by Haemophilus parainfluenzae. Infect Dis Clin Pract 2007; 15 (03) 206-208
• 2 O'Neil CR, Wilson E, Missaghi B. Bone and Joint Infections due to Haemophilus parainfluenzae: Case Report and Review of the Literature. Can J Infect Dis Med Microbiol 2016; 2016: 4503025 DOI: 10.1155/2016/4503025.
• 3 Olk DG, Hamill RJ, Proctor RA. Haemophilus parainfluenzae vertebral osteomyelitis. Am J Med Sci 1987; 294 (02) 114-116 DOI: 10.1097/00000441-198708000-00011.
• 4 Auten GM, Levy CS, Smith MA. Haemophilus parainfluenzae as a rare cause of epidural abscess: case report and review. Rev Infect Dis 1991; 13 (04) 609-612 DOI: 10.1093/clinics/13.4.609.
• 5 Beauvais C, Berenbaum F, Spentchian M, Prier A, Kaplan G. Early diagnosis of vertebral osteomyelitis due to a rare pathogen: Haemophilus parainfluenzae. J Rheumatol 1992; 19 (03) 491-493
• 6 Oill PA, Chow AW, Guze LB. Adult bacteremic Haemophilus parainfluenzae infections. Seven reports of cases and a review of the literature. Arch Intern Med 1979; 139 (09) 985-988 DOI: 10.1001/archinte.139.9.985.
• 7 Berbari EF, Kanj SS, Kowalski TJ. et al; Infectious Diseases Society of America. 2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults. Clin Infect Dis 2015; 61 (06) e26-e46 DOI: 10.1093/cid/civ482.
• 8 Modic MT, Feiglin DH, Piraino DW. et al. Vertebral osteomyelitis: assessment using MR. Radiology 1985; 157 (01) 157-166 DOI: 10.1148/radiology.157.1.3875878.
• 9 Desandre AR, Cottone FJ, Evers ML. Iliopsoas abscess: etiology, diagnosis, and treatment. Am Surg 1995; 61 (12) 1087-1091
• 10 López VN, Ramos JM, Meseguer V. et al; GTI-SEMI Group. Microbiology and outcome of iliopsoas abscess in 124 patients. Medicine (Baltimore) 2009; 88 (02) 120-130 DOI: 10.1097/MD.0b013e31819d2748.