Abstract
The incidence of extra pelvic infections due to vaginal microflora bacteria has increased as growth media and methods of isolation have improved. However, bone infections seem to be still relatively rare, and little is known about their risk factors, clinical presentation, treatment and final outcome. We describe here a spondylodiscitis due to Gardnerella vaginalis, Atopobium vaginae, Peptostreptococcus indolicus and Prevotella amnii, anaerobic bacteria from vaginal microbiota. Our patient had no obvious predisposing factor and recovered after antibiotic treatment. To our knowledge, this case is the first reported spondylodiscitis caused by polymicrobial vaginal flora in a healthy, immunocompetent woman.
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References
Fantoni M, Trecarichi E, Rossi B (2012) Epidemiological and clinical features of pyogenic spondylodiscitis. Eur Rev Med Pharmacol Sci 16:2–7
Graham S, Howes C, Dunsmuir R, Sandoe J (2009) Vertebral osteomyelitis and discitis due to Gardnerella vaginalis. J Med Microbiol 58:1382–1384
Nolla JM, Ariza J, Gómez-Vaquero C, Fiter J, Bermejo J, Valverde J, Escofet DR, Gudiol F (2002) Spontaneous pyogenic vertebral osteomyelitis in nondrug users. Semin Arthritis Rheum 31:271–278
Sobottke R, Seifert H, Fätkenheuer G, Schmidt M, Goßmann A, Eysel P (2008) Current diagnosis and treatment of spondylodiscitis. Deutsches Aerzteblatt Online 105:181–187
Srinivasa S, Wong K, Fitch KV, Wei J, Petrow E, Cypess AM, Torriani M, Grinspoon SK (2015) Effects of lifestyle modification and metformin on irisin and FGF21 among HIV-infected subjects with the metabolic syndrome. Clin Endocrinol 82:678–685
Smith SB, Ravel J (2017) The vaginal microbiota, host defence and reproductive physiology: vaginal microbiota in defence and physiology. J Physiol 595:451–463
Austin MN, Beigi RH, Meyn LA, Hillier SL (2005) Microbiologic response to treatment of bacterial vaginosis with topical clindamycin or metronidazole. J Clin Microbiol 43:4492–4497
Kavoussi SK, Pearlman MD, Burke WM, Lebovic DI (2006) Endometrioma complicated by tubo-ovarian abscess in a woman with bacterial vaginosis. Infect Dis Obstet Gynecol 2006:1–3
Nightingale L (1986) Cephalhematoma complicated by osteomyelitis presumed due to Gardnerella vaginalis. JAMA 256:1936–1937
Hodge TW Jr, Levy CS, Smith MA (1995) Disk space infection due to Gardnerella vaginalis. Clin Infect Dis 21:443–445
Sivadon-Tardy V, Roux A-L, Piriou P, Herrmann J-L, Gaillard J-L, Rottman M (2009) Gardnerella vaginalis acute hip arthritis in a renal transplant recipient. J Clin Microbiol 47:264–265
Stewart L, Sinha S, Madsen PJ, Glaser L, Chen HI, Culyba MJ (2018) Spinal epidural abscess caused by Gardnerella vaginalis and Prevotella amnii. Infect Dis Clin Pract 26:237–239
Hoarau G, Bernard S, Pavese P, Saragaglia D, Croize J, Maurin M (2012) Gardnerella vaginalis as a rare cause of prosthetic joint infection. J Clin Microbiol 50:4154–4156
Taillandier P, Roingeard C, Violette J, Leclère F-M, Faivre S (2020) Septic shock caused by Gardnerella vaginalis and Atopobium vaginae. IDCases 21:e00876
García-Sánchez JE, García-Sánchez E, Martín-del-Rey Á, García-Merino E (2015) Las bacterias anaerobias 150años después de su descubrimiento por Pasteur. Enferm Infecc Microbiol Clin 33:119–128
Shah NN, Nanjappa S, Greene JN (2017) Osteomyelitis and hip abscess caused by Gardnerella vaginalis: a case report. Infect Dis Clin Pract 25:162–164
Purushothaman B, Lakshmanan P, Gatehouse S, Fender D (2010) Spondylodiscitis due to Prevotella associated with ovarian mass—a rare case report and review of literature. World Neurosurgery 73:119–122
Dahya V, Chalasani P, Ramgopal M (2015) Peptostreptococcus endocarditis presenting as lumbar discitis in an immunocompromised patient. Am J Med Sci 349:187–188
Joughin E, McDougall C, Parfitt C, Yong-Hing K, Kirkaldy-Willis W (1991) Causes and clinical management of vertebral osteomyelitis in Saskatchewan. Spine 16:261–264
Fouquet B, Goupille P, Jattiot F, Cotty P, Lapierre F, Valat JP, Amouroux J, Benatre A (1992) Discitis after lumbar disc surgery. Features of ‘“aseptic”’ and ‘“septic”’ forms. Spine 17:356–358
Dufour V, Feydy A, Rillardon L, Redondo A, Lepage L, Bert F, Belmatoug N, Fantin B (2005) Comparative study of postoperative and spontaneous pyogenic spondylodiscitis. Semin Arthritis Rheum 34:766–771
Gouliouris T, Aliyu SH, Brown NM (2010) Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother 65:iii11–iii24
Weinstein MA, Eismont FJ (2005) Infections of the spine in patients with human immunodeficiency virus. J Bone Jt Surg Am 87:604–609
Rezai AR, Errico TJ (1999) Contemporary management of spinal osteomyelitis. Neurosurgery 44:1018–1026
Enoch DA, Cargill JS, Laing R, Herbert S, Corrah TW, Brown NM (2007) Value of CT-guided biopsy in the diagnosis of septic discitis. J Clin Pathol 61:750–753
Jespers V, Hardy L, Buyze J, Loos J, Buvé A, Crucitti T (2016) Association of sexual debut in adolescents with microbiota and inflammatory markers. Obstet Gynecol 128:22–31
Mitchell CM, Fredricks DN, Winer RL, Koutsky L (2012) Effect of sexual debut on vaginal microbiota in a cohort of young women. Obstet Gynecol 120:1306–1313
Petrina MAB, Cosentino LA, Rabe LK, Hillier SL (2017) Susceptibility of bacterial vaginosis (BV)-associated bacteria to secnidazole compared to metronidazole, tinidazole and clindamycin. Anaerobe 47:115–119
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AK wrote the paper: wrote the paper except the laboratory part; other contribution: coordination of exploration and of take care of the patient. FEA performed laboratory tests. HBA other contribution: taking care of the patient. SC other contribution: taking care of the patient. EC wrote the paper: taking part in discussion corrections; other contribution: laboratory analysis. FJ wrote the paper: wrote the laboratory part, discussion corrections; other contribution: laboratory analysis.
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Kolakowska, A., El Alaoui, F., Ben Alba, H. et al. Vaginal microbiota as an unusual cause of spondylodiscitis. Arch Gynecol Obstet 306, 109–114 (2022). https://doi.org/10.1007/s00404-022-06432-4
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DOI: https://doi.org/10.1007/s00404-022-06432-4
Keywords
- Spondylodiscitis
- Vaginal microbiota
- Gardnerella vaginalis
- Atopobium vaginae
- Peptostreptococcus indolicus
- Prevotella amnii