Anaerobic spondylodiscitis: case series and systematic review.
BACKGROUND
Bacterial spondylodiscitis is rarely caused by anaerobic organisms. We describe two patients with lumbar vertebral osteomyelitis and discitis caused by anaerobic bacteria, including an unusual occurrence after an endodontic procedure, and review the salient clinical features and outcomes of 31 previously reported cases.


METHODS
Case reports and review of the literature.


RESULTS
Median age at presentation was 65 years, with a male-to-female ratio of 2:1. The most common presenting symptoms were back pain, fever, and neurologic deficits. The lumbar spine was most frequently involved (43%); an equal number of cases involved contiguous extension or hematogenous spread. Causative anaerobes were recovered from disk space or vertebrae (13), blood (4), and/or soft tissue abscess and included Bacteroides species (12), Propionibacterium acnes (7), Peptococcus species (4), Peptostreptococcus species and Clostridium species (3 each), Corynebacterium diphtheroides and Fusobacterium species (2 each), and unspecified anaerobes (3).


CONCLUSIONS
Apart from specific antibiotic selection, medical treatment and outcomes for anaerobic spondylodiscitis are similar to those for aerobic vertebral disk infection.
Saeed
Musab U
MU
Department of Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, ND 58122, USA. musabsaeed@meritcare.com
Mariani
Paul
P
Martin
Candelaria
C
Smego
Raymond A
RA
Potti
Anil
A
Tight
Robert
R
Thiege
David
D
D000368:Aged; D001424:Bacterial Infections / Q000382:microbiology* / Q000473:pathology; D015299:Discitis / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D011859:Radiography