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Diagnosis, Treatment, and Outcome of Stenotrophomonas maltophilia Discitis and Cervical Osteomyelitis

A Case Report and Review of the Literature

Ilyas, Haariss, MD1,a; Tabaie, Sean, MD1; Place, Howard, MD1

doi: 10.2106/JBJS.CC.O.00117
Case Reports
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Disclosures

Case: A fifty-six-year-old man presented with a three-month history of worsening neck pain and weakness of the right arm. Magnetic resonance imaging revealed C5-C6 osteomyelitis and discitis and a prevertebral abscess from C3 to C7. He underwent staged instrumented anterior and posterior spinal fusion from C5 to C7, with an anterior C5-C6 cervical discectomy and a C6 corpectomy. Intraoperative cultures exhibited growth of Stenotrophomonas maltophilia. The patient subsequently received five months of oral trimethoprim/sulfamethoxazole therapy. At twelve months postoperatively, he had full recovery of motor strength bilaterally.

Conclusion: Osteomyelitis with S. maltophilia is associated with agricultural-machinery-related injuries. Surgical intervention for cervical osteomyelitis should be considered if the patient presents with a neurologic deficit or a paravertebral abscess.

1Saint Louis University School of Medicine, St. Louis, Missouri

aE-mail address for H. Ilyas: ilyash@ccf.org

Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated
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