Acute Pyogenic Spondylitis Caused by Streptococcus Constellatus in an Obese Patient: A Case Report

Streptococcus anginosus spondylodiscitis causing incapacitating back pain in an immunocompetent patient: A case report

Pyogenic spondylodiscitis is uncommon and usually presents in the setting of immunosuppression. Streptococcus anginosus group are opportunistic pathogens that rarely cause this infection. We present a case of an immunocompetent 45-year-old male with extreme lower back pain, not even relieved by opioids. A magnetic resonance imaging done the day before arrival showed multiple lumbar disk degeneration and lumbar spondylosis. Initial examinations did not show significant alteration. During inpatient admission, his values of erythrocyte sedimentation rate and C-reactive protein increased, and a new magnetic resonance imaging with contrast revealed signs of spondylodiscitis at the L2-L3 level. He underwent open surgery for tissue sampling and stabilization of the affected segment. Blood culture, disk sampling culture, and myeloculture were positive for S. anginosus. Additional examinations were negative for immunosuppression or any underlying condition, and the dental evaluation only showed mild gingivitis. The patient received intravenous antibiotics, and the pain significantly improved after surgery. He was finally discharged and completed 8 weeks of antibiotics. The erythrocyte sedimentation rate and C-reactive protein values were normal 6 weeks after surgery, and on a 1-year follow-up, the magnetic resonance imaging showed stable post-surgical changes with no signs of infection.

Empyema caused by Streptococcus constellatus in a patient infected with HIV: a case report and literature review

BACKGROUND

Empyema caused by Streptococcus constellatus (S. constellatus) is rare in patients with HIV. To analyze the clinical data of a patient living with HIV (PLHIV), who got empyema caused by S. constellatus, investigating the diagnosis and treatment of this disease through literature review to improve the clinical understanding of this disease.

CASE PRESENTATION

We have reported here a 58-year-old male PLHIV with cough, wheezing, and fever for 20 days. He has a history type 2 diabetes, alcohol abuse, and a teeth extracted. Chest computed tomography revealed multiple encapsulated pleural effusions, pneumatosis, and partial compressive atelectasis in the right lung. Submission of pleural efusions timely, and then cultures revealed S. constellatus. After comprehensive treatment, including antibiotics, closed pleural drainage, and intrapleural injection of urokinase, the pleural efusion was absorbed, and chest computed tomography also confirmed the improvement.

CONCLUSIONS

S. constellatus should not be neglected as a pus pathogen in patients with HIV. comprehensive treatment is important for empyema of S. constellatus.

Acute Spinal Epidural Abscess of the Cervical Spine Caused by Streptococcus constellatus Leads to Paraplegia in an Adult: A Case Report

The incidence of a spinal epidural abscess (SEA), which can cause serious neurological complications, is low; however, the incidence of SEA caused by Streptococcus is even lower, most of which are reported in the thoracolumbar spine and lumbosacral segment. We reported a case of cervical SEA caused by Streptococcus constellatus infection, resulting in paralysis of the patient. The acute onset of SEA in a 44-year-old male led to decreased upper limb muscle strength, lower limb paralysis, and loss of bowel and bladder function, and imaging and blood tests suggested pyogenic spondylitis. Emergency decompression surgery and antibiotic therapy were given, the patient gradually recovered, and the muscle strength of the lower limbs gradually improved. This case report suggests the importance of early decompressive surgery and effective antibiotic therapy.

Aggressive Pyogenic Spondylitis Caused by S. constellatus: A Case Report

Streptococcus constellatus (SC) is a species of Streptococcus belonging to the Streptococcus anginosus group, along with Streptococcus anginosus and Streptococcus intermedius. Despite its commensal nature, underlying risk factors and medical conditions might lead to various anatomic site infections caused by this opportunistic pathogen. Although SC infections have mostly been associated with bacteremia, some case reports of abscess and empyema formation have been documented. Herein, we report a case of a middle-aged female patient who initially presented with radiculopathy symptoms. Subsequent neurologic imaging revealed a pyogenic abscess along paravertebral muscles, which was found to be caused by SC. The patient was successfully treated with abscess drainage from the lumbar zone and antibiotics, and the symptoms of radiculopathy have completely resolved.