Nosocomial spondylodiskitis with epidural abscess and CSF fistula cured with quinupristin/dalfopristin and linezolid

Infez Med. 2006 Jun;14(2):99-101.

Abstract

Nosocomial infections after spinal surgery are relatively uncommon but potentially serious. The goal of diagnostic evaluation is to determine the extent of infection and identify the microorganism involved. Neuroimaging provides accurate information on correct topography, localization and propagation of the infection. Microbiological data are able to give aetiological causes. In this patient with severe, chronic polymicrobial spine infection with epidural abscess and CSF fistula due to multidrug-resistant organisms, the cure was achieved with long-term antimicrobial specific therapy with quinupristin-dalfopristin (50 days) and linezolid (100 days) with mild side effects. This positive result was due to combined medical and surgical treatment.

Publication types

  • Case Reports

MeSH terms

  • Acetamides / therapeutic use*
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteria / isolation & purification
  • Cerebrospinal Fluid / microbiology
  • Combined Modality Therapy
  • Cross Infection / drug therapy*
  • Cross Infection / etiology
  • Cross Infection / surgery
  • Curettage
  • Device Removal
  • Discitis / drug therapy*
  • Discitis / etiology
  • Discitis / surgery
  • Epidural Abscess / drug therapy*
  • Epidural Abscess / etiology
  • Epidural Abscess / surgery
  • Female
  • Fistula / cerebrospinal fluid
  • Fistula / etiology
  • Fistula / microbiology
  • Fluconazole / therapeutic use
  • Fungi / isolation & purification
  • Humans
  • Internal Fixators / adverse effects
  • Laminectomy
  • Linezolid
  • Lumbar Vertebrae / microbiology*
  • Meropenem
  • Methicillin Resistance
  • Middle Aged
  • Osteomyelitis / etiology
  • Osteomyelitis / microbiology
  • Oxazolidinones / therapeutic use*
  • Parkinson Disease / complications
  • Prosthesis-Related Infections / drug therapy*
  • Prosthesis-Related Infections / etiology
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / surgery
  • Reoperation
  • Skin Diseases / cerebrospinal fluid
  • Skin Diseases / etiology
  • Skin Diseases / microbiology
  • Spinal Diseases / cerebrospinal fluid
  • Spinal Diseases / etiology
  • Spinal Diseases / microbiology
  • Spinal Stenosis / complications
  • Spinal Stenosis / surgery
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / etiology
  • Staphylococcal Infections / surgery
  • Thienamycins / therapeutic use
  • Virginiamycin / therapeutic use*

Substances

  • Acetamides
  • Anti-Bacterial Agents
  • Oxazolidinones
  • Thienamycins
  • Virginiamycin
  • quinupristin-dalfopristin
  • Fluconazole
  • Meropenem
  • Linezolid