Spinal infection caused by ESBL-producing Klebsiella pneumoniae treated with temocillin.
A case of cervical epidural abscess in a 63-year-old woman with a complex gastrointestinal surgical history is reported. The presenting symptom was neck pain, and blood analysis demonstrated raised erythrocyte sedimentation rate and C-reactive protein. MR imaging of the cervical spine revealed cervical discitis, osteomyelitis, and epidural collection. An ESBL-producing strain of Klebsiella pneumoniae, isolated from a previous episode of bacteraemia, was the causative organism. Surgical treatment was not possible and initial carbapenem therapy was aborted due to development of neutropaenia, and treatment continued with an extended course of temocillin. After 12 weeks of antibiotics the patient was pain-free with radiological improvement and resolution of blood markers of infection.
Barton
Edward
E
Department of Microbiology, North Bristol NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK. edward.barton@nbt.nhs.uk
Flanagan
Paul
P
Hill
Simon
S
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002574:Cervical Vertebrae / Q000382:microbiology; D015299:Discitis / Q000188:drug therapy* / Q000382:microbiology; D020802:Epidural Abscess / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology*; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology; D010406:Penicillins / Q000627:therapeutic use*; D016896:Treatment Outcome; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis
D000900:Anti-Bacterial Agents; D010406:Penicillins; C031367:temocillin; D001618:beta-Lactamases