Methods: A 55-year-old Japanese man was admitted with fever and low back pain of one-month duration. Thirty days prior to admission, magnetic resonance imaging (MRI) of the spine showed only spinal canal stenosis. Four days prior to admission, follow-up MRI of the spine revealed findings consistent with L4/5 vertebral osteomyelitis. On the day of admission, L4/5 intervertebral disk tissue aspiration was performed.
Results: Tissue and blood culture results were negative. However, broad-range PCR targeting 16S rDNA and specific PCR for the H. cinaedi gyrB gene confirmed the diagnosis of an H. cinaedi infection. The patient was treated with ceftriaxone for eight weeks. The patient’s low back pain and serum inflammatory markers improved and he was discharged.
Conclusion: H. cinaedi vertebral osteomyelitis identified by blood cultures has been reported. To our knowledge, this is the first report of H. cinaedi vertebral osteomyelitis identified by molecular techniques directly from intervertebral disk tissue in an immunocompetent adult. H. cinaedi is known to be difficult to grow in culture. The use of molecular diagnostic techniques can be a powerful complement for the detection of culture-negative vertebral osteomyelitis.
R. Oda, None
K. Ohkusu, None