Linezolid therapy for pediatric thoracic spondylodiscitis due to Staphylococcus aureus sepsis.
We report the case of an immunocompetent child with spondylodiscitis as a result of staphylococcal sepsis, which was successfully treated with linezolid. The patient was admitted with fever and circumferential swelling in the paradorsal region, which was evident only in the flexed back position. A chest X-ray showed a pleural effusion with pneumonitis and dorsal kyphosis. Following the yield of Staphylococcus aureus from blood cultures, the initial therapy of ceftriaxone and amikacin was changed to vancomycin. However, the dorsal swelling increased further and imaging investigations showed destruction of the vertebral bodies D8-D10 and surrounding tissue swelling. Vancomycin was changed to linezolid, and the patient began to improve; a full recovery was made. Our case suggests that even if spondylodiscitis is rare in the pediatric age-group, particularly as a complication of staphylococcal sepsis, early diagnosis and prompt and appropriate therapy are important to prevent severe complications.
Krzysztofiak
Andrzej
A
Department of Pediatric Medicine, Infectious Diseases Unit, Children's Hospital Bambino Gesù, Piazza S. Onofrio No. 4, Rome, Italy. krzy@opbg.net
Pagnotta
Gaetano
G
Lancella
Laura
L
Bozzola
Elena
E
La Rosa
Guido
G
D000081:Acetamides / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D015299:Discitis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D007223:Infant; D000069349:Linezolid; D008279:Magnetic Resonance Imaging; D008297:Male; D023303:Oxazolidinones / Q000627:therapeutic use*; D018805:Sepsis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013904:Thoracic Vertebrae
D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D000069349:Linezolid