title: Three cases of vertebral osteomyelitis caused by Streptococcus dysgalactiae subsp. equisimilis.
abstract: Three cases of vertebral osteomyelitis caused by Streptococcus dysgalactiae subsp. equisimilis (Strep. equisimilis) are presented here. All three cases presented with fever, back pain, general malaise and weight loss for at least 4 weeks. Diagnosis was established by culture of a spinal biopsy and/or positive blood cultures together with radiological findings. In all three cases, 6-12 weeks of antibiotics were curative without recourse to surgery. The ability of Strep. equisimilis to cause vertebral osteomyelitis is highlighted. The need is emphasized for biopsy and microbiological investigation in patients presenting with back pain, fever, weight loss and evidence of a spinal lesion on imaging, even if neoplastic disease is suspected. Prolonged antibiotic therapy (at least 6 weeks) seems to be indicated.
authors.affiliation: Department of Orthopaedics, Royal Wolverhampton Hospital NHS Trust, Wolverhampton WV10 0QP, UK 2Department of Microbiology, Leeds General Infirmary, Great George's Street, Leeds LS2 9JT, UK.
authors.forename: Aravind
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Orthopaedics, Royal Wolverhampton Hospital NHS Trust, Wolverhampton WV10 0QP, UK 2Department of Microbiology, Leeds General Infirmary, Great George's Street, Leeds LS2 9JT, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sandoe
authors.affiliation: Department of Orthopaedics, Royal Wolverhampton Hospital NHS Trust, Wolverhampton WV10 0QP, UK 2Department of Microbiology, Leeds General Infirmary, Great George's Street, Leeds LS2 9JT, UK.
authors.forename: Naresh
authors.initials: N
authors.lastname: Kumar
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001416:Back Pain; D001706:Biopsy; D005334:Fever; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D011859:Radiography; D013131:Spine / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D013290:Streptococcal Infections / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D013291:Streptococcus / Q000302:isolation & purification*; D015431:Weight Loss
chemical_list: D000900:Anti-Bacterial Agents