Case Report

Granulicatella adiacens and Abiotrophia defectiva Native Vertebral Osteomyelitis: Three Cases and Literature Review of Clinical Characteristics and Treatment Approach

Table 1

Clinical characteristics, antibiotic treatment, and outcome of Granulicatella adiacens and Abiotrophia defectiva NVO cases.

Reference (year of publication)Patient age, sexClinical presentationPast medical historyConcomitant endocarditisBacteremiaVertebral infection sitePositive microbiological specimensMethods for microbial identificationMicrobiological identificationAntibiotic regimenTotal duration of treatmentSpinal surgical interventionOutcome

Our first case (2017)50, maleCardiogenic shock, fever, back painNoneYesYesL3-L4, L5-S1Blood culturesVitek MSGranulicatella adiacensVancomycin + ceftriaxone + gentamycin for 2 weeks, ceftriaxone for 2 weeks, amoxicillin po for 2 weeks6 weeksNoCured
Our second case (2017)47, maleFever, back painHypertension, L5 disc herniationNoYesL5-S1Blood culturesVitek MSGranulicatella adiacensVancomycin + ceftriaxone for 1 week, ceftriaxone for 3 weeks, amoxicillin po for 2 weeks6 weeksNoCured
Our third case (2018)75, femaleBack painPrevious mitral valvuloplastyNoYesL4-L5Blood cultures + bone biopsyVitek MSAbiotrophia defectivaVancomycin for 2 weeks, teicoplanin for 6 weeks8 weeksNoNA
[15] (2017)54, femaleFever, back painPatent ductus arteriosusNo (pulmonary artery endoarteritis)YesL5-S1Blood culturesVitek 2 system + 16S rNA sequencingAbiotrophia defectivaPenicillin G + gentamicinPlanned 6 weeksNoNA
[13] (2017)48, maleBack painIntravenous drug abuse, mitral valve prolapse, HCV infectionNoNoL3-L4 + L3-L5 epidural phlegmonVertebral, disk and paraspinal muscles biopsyNDGranulicatella/Abiotrophia spp.Vancomycin for 6 weeks + cefepime in the first day6 weeksNoCured
[12] (2017)61, maleBack painDiabetes, hypertensionNoNoL3-L4Disk biopsyVitek 2 systemGranulicatella adiacensCeftriaxone + gentamycin for 6 weeks6 weeksNoCured
[11] (2016)46, maleBack painDiabetes, recent dental procedureNoNoL2 inferior endplateBone biopsyPCR (not specified)Granulicatella adiacensVancomycin for 6 weeks6 weeksYes (L1-L3 fixation and interbody cage position in L2)Cured
[10] (2015)62, maleBack pain, feverHypertensionNoYesT10-T12 with spinal abscessBlood culturesNDAbiotrophia adiacensVancomycin for 6 weeks6 weeksYes (laminectomy with T9-L2 fusion surgery)Cured
[9] (2013)48, femaleBack pain, feverParkinson’s diseaseNoYesL3-L5Blood cultures + disk biopsy16S rNA sequencingAbiotrophia adiacensAmpicillin for 6 weeks6 weeksNoCured
[8] (2010)73, maleBack pain, feverHypertension, hyperlipidemiaNoYesL3-L4Blood culturesVitek 2 system + 16S rNA sequencingGranulicatella adiacensPenicillin G + gentamicin for 6 weeks, po amoxicillin for 9 weeks15 weeksNoCured
[14] (2005)51, maleBack painMitral valvulopathy, recent dental procedureNoYesL2-L3, L5-S1, right sacroiliac jointBlood cultures16S rNA sequencingAbiotrophia defectivaAmoxicillin + gentamicin (stopped on day 5) + oral rifampicin, po amoxicillin for 11 weeks + po rifampicin for 10 weeks14 weeksNoCured
[7] (2002)68, maleBack pain, feverDiabetes, coronary artery disease, infrarenal aorta prosthetic replacement, AF and AV block with VVI PMYes (PM lead)YesT10-T11Blood culturesbioMérieux Rapid ID 32 Strep systemGranulicatella adiacensPenicillin + gentamicin + rifampinNDNoCured
[6] (1998)45, maleBack pain, feverNDYesYesL2-L4Blood culturesNDAbiotrophia adiacensPenicillin for 2 weeks, po clindamycin for 2 weeks4 weeksNoCured
[6] (1998)50, maleBack pain, feverNDYesYesL3-L5Blood culturesNDAbiotrophia adiacensPenicillin + gentamicin for 2 weeks, ceftriaxone for 2 weeks4 weeksNoCured

NA: not assessed; ND: not described; PM: pacemaker; AF: atrial fibrillation; AV: atrioventricular.