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Hematogenous Coagulase-Negative Staphylococcal Vertebral Osteomyelitis: Case Reports and Review of the Literature

Riddell IV, James MD*; Quint, Douglas J. MD; Kazanjian, Powel H. MD, PhD*

Infectious Diseases in Clinical Practice: November 2012 - Volume 20 - Issue 6 - p 400–403
doi: 10.1097/IPC.0b013e3182639f96
Original Articles

Abstract: Vertebral osteomyelitis (VO) is an infection that can lead to significant morbidity including paralysis and chronic pain. Identifying the responsible organism poses a challenge to the physician. Vertebral aspirates are often used to sample the infected region in an attempt to identify the responsible microbe when cultures of blood are negative or reveal an organism not typically associated with VO. To identify the clinical features of patients with coagulase-negative staphylococcal (CNS) VO, we reviewed 272 vertebral aspirates obtained at our institution over 5 years. We identified 7 patients with cultures that yielded CNS. All patients had indwelling intravascular lines or devices. All patients in whom blood cultures were performed had CNS isolated from cultures of blood. Four of the 7 patients had resolution of the infection with antibiotic treatment alone, and 2 patients required surgical intervention. Coagulase-negative Staphylococcus may be an etiologic pathogen when it is isolated from multiple cultures of blood in patients with VO and additional risk factors including an indwelling intravascular line or device.

From the *Division of Infectious Diseases, Department of Internal Medicine and †Division of Neuroradiology and MRI, Department of Radiology, University of Michigan Medical School, Ann Arbor, MI.

Correspondence to: James Riddell IV, MD, 1500 E Medical Center Dr, 3120 Taubman Center, Ann Arbor, MI 48109-5378. E-mail: jriddell@umich.edu.

The authors have no funding or conflicts of interest to disclose.

© 2012 Lippincott Williams & Wilkins, Inc.