Anaerobic Spondylodiscitis due to Fusobacterium Species: A Case Report Review of the Literature

Atypical presentation of Lemierre's syndrome: case report and literature review

BACKGROUND

The classic Lemierre's syndrome refers to a septic thrombosis of the internal jugular vein, usually caused by a Fusobacterium necrophorum infection starting in the oral cavity, and typically complicated by pulmonary emboli. However, unusual forms of the disorder have been rarely reported.

CASE PRESENTATION

We describe an unusual case of a previously healthy 58-year-old male with Lemierre's syndrome, manifesting with lumbar pain and fever. A thrombosis of the iliac veins and abscesses in the right iliac and the left psoas muscles was diagnosed by a computed tomography scan, together with a right lung pneumonia complicated by pleural effusion and an L4-L5 spondylodiscitis. Blood culture and pus drainage were positive for Fusobacterium nucleatum and an atypical Lemierre's syndrome was suspected. The patient was treated with anticoagulant therapy for 12 weeks and intravenous antibiotic therapy for 6 weeks with a good evolution and resolution of the thrombosis.

CONCLUSIONS

This case illustrates the thrombogenic and thromboembolic tendency of Fusobacterium nucleatum and its potential invasiveness, regardless of the site of primary infection. The concept of an atypical Lemierre's syndrome is redefined here to take into consideration non-cervical sites.

Mycobacteria Intracellulare Spondylodiscitis Presenting as Progressive Consecutive Vertebral Sclerosis: A Case Report

INTRODUCTION

Non-tuberculous mycobacteria (NTM) are slow-growing organisms affecting both immunocompromised and immunocompetent patients. As compared to tuberculosis, they pose formidable challenge in successful management beginning with diagnosis extending through its treatment.

CASE REPORT

Our case highlights unusual spinal presentation of NTM, intricacies in diagnosis, and successful management.

CONCLUSION

As the prevalence of NTM is rising, it is important as clinicians to understand unique aspects which differ from tuberculosis for appropriate and successful treatment.