Service de Bactériologie, Centre Hospitalier et Universitaire d'Amiens, 1 place Victor Pauchet, Amiens Cedex 1, France.
Int J Infect Dis. 2010 Sep;14 Suppl 3:e261-4. doi: 10.1016/j.ijid.2009.11.007. Epub 2010 Feb 18.
We present the first case of human spondylodiscitis due to Shewanella algae. Our patient did not have any predisposing factors. The portal of entry was probably a cutaneous lesion on the leg, exposed to seawater. Bacteria were isolated in pure culture from a needle biopsy specimen of the vertebral disk. Automated identification systems identified the organism as Shewanella putrefaciens. However, molecular biology identified it as S. algae. Treatment with ceftriaxone and amikacin, then ciprofloxacin successfully addressed the infection. We also review four published cases of human osteoarticular infections caused by Shewanella spp: two cases of arthritis and two cases of osteomyelitis. Two patients had predisposing factors, and contact with water was found in two cases. The clinical, radiological and biological characteristics of S. algae spondylodiscitis are indistinguishable from those of spondylodiscitis of other causes. A cutaneous lesion with exposure to water is a potential portal of entry. Molecular typing is necessary to obtain a precise bacteriological identification.
我们报告首例由海生假单胞菌引起的人类脊椎椎间盘炎。我们的患者没有任何易感因素。感染的可能门户是腿部暴露于海水中的皮肤损伤。从椎间盘的针吸活检标本中纯培养分离出细菌。自动鉴定系统将该生物体鉴定为腐生海单胞菌。然而,分子生物学将其鉴定为海生藻。头孢曲松和阿米卡星治疗,然后是环丙沙星成功解决了感染。我们还回顾了四起因海生假单胞菌引起的人类骨关节感染病例:两例关节炎和两例骨髓炎。两名患者有易感因素,两例与水接触。海生藻性脊椎椎间盘炎的临床、放射学和生物学特征与其他原因引起的脊椎椎间盘炎无法区分。有皮肤损伤并接触水是潜在的感染门户。需要分子分型以获得准确的细菌学鉴定。