Nocardia farcinica Spinal Osteomyelitis

Graat, Harm C. A., Van Ooij, André, Day, Gregory A. and McPhee, I. Bruce (2002) Nocardia farcinica Spinal Osteomyelitis. Spine, 27 10: E253-E257.

Author Graat, Harm C. A.
Van Ooij, André
Day, Gregory A.
McPhee, I. Bruce
Title Nocardia farcinica Spinal Osteomyelitis
Journal name Spine   Check publisher's open access policy
ISSN 0362-2436
Publication date 2002-05-15
Sub-type Article (original research)
Volume 27
Issue 10
Start page E253
End page E257
Total pages 5
Place of publication United States
Publisher Lippincott Williams & Wilkins
Language eng
Subject 11 Medical and Health Sciences
Formatted abstract
Study Design. A case of disseminated Nocardia farcinica infection with spine involvement is reported.

Objective. To describe the first case of Nocardia farcinica spinal osteomyelitis, and to propose spine instrumentation with debridement and multiple antibiotics for treatment of nocardia spinal osteomyelitis.

Summary of Background Data. Only 11 cases involving Nocardia asteroides spinal osteomyelitis have been reported over the past 40 years. These case reports describe various presentations and treatments of nocardia spinal osteomyelitis.

Methods. A 54-year-old nonambulant, paraparetic man was admitted to the authors’ hospital with acutely increased low back pain, fever, and signs of dementia. A disseminated Nocardia farcinica infection including spinal osteomyelitis at T11, T12, L1, L2, and L4; epidural abscess T10–L4, L5–S1 discitis, empyemas, cerebral abscess, and bilateral psoas abscess was noted.

Results. Antibiotic therapy, multiple debridements, and posterior instrumentation were performed to palliate the Nocardia farcinica infection. At a recent 3-year follow-up assessment, the patient was independent and ambulant. He had been off antibiotics for 5 months.

Conclusions. Previous case reports of nocardia spinal osteomyelitis describe treatment with antibiotics, debridements, and arthrodesis with autologous bone graft. Prolonged recumbency ensued. In the reported case, a combination of antibiotics, debridements, arthrodesis, and posterior instrumentation for immediate stabilization of the spine resulted in a favorable outcome at 3 years.
Keyword Nocardia farcinica
posterior instrumentation
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Thu, 13 Apr 2006, 18:53:26 EST