Central line-associated bacteremia caused by drug-resistant Staphylococcus caprae after chemotherapy for acute myelogenous leukemia

Subacute osteomyelitis due to Staphylococcus caprae in a teenager: A case report and review of the literature

BACKGROUND

Staphylococcus caprae (S. caprae) is a human commensal bacterium which can be detected in the nose, nails, and skin. It can be responsible for heterogeneous infections such as bacteremia, endocarditis, pneumonia, acute otitis externa, peritonitis, and urinary tract infections. Bone and joint infections due to S. caprae have also been reported, but most of them resulted from the infection of orthopedic devices, especially joint prostheses and internal osteosynthesis devices. Rare cases of primary osteoarticular infections caused by S. caprae have been described, including osteitis, arthritis, or spondylodiscitis.

CASE SUMMARY

We report an unusual case of subacute osteomyelitis in a toe phalanx caused by S. caprae in a 14.5-year-old girl.

CONCLUSION

Subacute S. caprae osteomyelitis is a little-known and probably underestimated community-acquired infectious disease. This microorganism’s pathogenicity should be seen as more than a classic nosocomial orthopedic device infection.

Subacute osteomyelitis due to Staphylococcus caprae in a teenager: A case report and review of the literature

BACKGROUND

Staphylococcus caprae (S. caprae) is a human commensal bacterium which can be detected in the nose, nails, and skin. It can be responsible for heterogeneous infections such as bacteremia, endocarditis, pneumonia, acute otitis externa, peritonitis, and urinary tract infections. Bone and joint infections due to S. caprae have also been reported, but most of them resulted from the infection of orthopedic devices, especially joint prostheses and internal osteosynthesis devices. Rare cases of primary osteoarticular infections caused by S. caprae have been described, including osteitis, arthritis, or spondylodiscitis.

CASE SUMMARY

We report an unusual case of subacute osteomyelitis in a toe phalanx caused by S. caprae in a 14.5-year-old girl.

CONCLUSION

Subacute S. caprae osteomyelitis is a little-known and probably underestimated community-acquired infectious disease. This microorganism's pathogenicity should be seen as more than a classic nosocomial orthopedic device infection.

A rare lumbar pyogenic spondylodiscitis caused by staphylococcus caprae with initial misdiagnosis: case report and literature review

Background

Staphylococcus caprae (Sc) is an uncommon causative organism for human. Lumbar pyogenic spondylodiscitis (LPS) of Sc is extremely rare and only a few cases have been reported. As far as we know, there is no specific literature on the diagnosis and treatment for LPS of Sc with L5 nerve root irritation.

Case presentation

A 65-year-old male patient complained of chronic low back pain for 10 years, acute worsening with radiating pain to left lower extremity over a month. Physical examination revealed tenderness point on his low back, 3/5 dorsiflexor strength in his left 1st toe and decreased sensation of pin prick over the left lateral shank and medial dorsal foot. The individual was initially misdiagnosed with lumbar disc herniation (LDH) without further examination in outpatient, which was then found to be LPS of Sc with L5 nerve root irritation after admission to our hospital. Magnetic resonance images (MRI) of lumbar spine exhibited inflammation signal at L4-L5 level of the vertebral body and disc with hypointense on T1-weighted images (T1-WI) and hyperintense on T2-weighted images (T2-WI). The causative organism was confirmed by the culture of irrigation fluid obtained from L5 vertebrae by needle puncture. After systemic conservative treatment including using sensitive antimicrobial agents and immobilization, the rare infection was finally cured. The patient also showed a satisfactory recovery during the 36-month follow-up period.

Conclusions

Confirming the diagnosis and identifying the causative organism as soon as possible is the key point for the treatment of LPS. LPS of Sc causing nerve root irritation is rare but curable with early diagnosis and proper therapy. The culture of irrigation fluid obtained from vertebrae by needle puncture may be an effective and sensitive attempt for potential infection of spine to identify the causative organism at early stage of the disease.

Staphylococcus caprae: A Skin Commensal with Pathogenic Potential

Staphylococcus caprae (S. caprae) is a catalase-positive, coagulase-negative organism that was first isolated from goat milk, and was later found to colonize healthy human skin, nails, and nasal mucosa. Rarely, this commensal organism can become pathogenic in humans. S. caprae has been implicated in a variety of human infections, with the highest incidence being in bone and joint infections. We describe a man who, after receiving facet joint injections for back pain, developed native vertebral discitis, vertebral osteomyelitis with phlegmon, and bilateral psoas abscesses, from which S. caprae was isolated.

Staphylococcus caprae bacteraemia and native bone infection complicated by therapeutic failure and elevated MIC: a case report

Introduction.Staphylococcus caprae is a coagulase-negative staphylococcus that has been reported in several cases as a human pathogen. However, it has rarely been reported as pathogen in native bone. Furthermore, the reported MIC levels noted in the literature for vancomycin were <2 µg ml⁻¹making vancomycin a first line choice for infected patients.

Case presentation. We report a case of Staphylococcus caprae causing osteomyelitis of the lumbar spine and bacteraemia and resulting in sepsis and ultimately the demise of a patient despite appropriate prolonged antibiotic therapy.

Conclusion.Staphylococcus caprae has been reported as a human pathogen since 1983 when it was discovered. We report a case involving native bone infection which is rare in the absence of mechanical hardware. Furthermore, this strain had an elevated MIC for vancomycin which has not been reported in the literature.