Corynebacterium striatum is Not Just a Contaminant: Experience with Antibiotic Treatment of Spondylodiscitis in an Immunocompetent Adult

棒状杆菌并非仅仅是污染物:免疫功能正常的成年人使用抗生素治疗脊椎炎的经验

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Abstract

BACKGROUND: Corynebacterium striatum is a commensal skin agent rarely described as a cause of infective spondylodiscitis. In this study, we report the first case of an infected patient who was successfully treated with conservative measures. CASE PRESENTATION: A 54-year-old immunocompetent patient presented with progressive low back pain that had persisted for 1 month. Magnetic resonance imaging revealed abnormal signals in the L4-L5 vertebrae, indicating lumbar spine infection. Laboratory investigations revealed elevation of the serum C-reactive protein level and erythrocyte sedimentation rate. Blood and disc biopsy tissue cultures produced cream-colored round raised colonies on blood agar plates, which were identified as C. striatum using matrix-assisted laser desorption ionization time-of-flight mass spectrometry and 16S rRNA sequencing. Based on the antibiotic sensitivity test results, vancomycin and linezolid were sequentially administered to treat C. striatum infection; however, this strategy proved ineffective after 12 days. Despite delayed symptomatic treatment, the patient was successfully treated with a 2-week course of linezolid based on the use of amikacin to control other pathogens. CONCLUSION: C. striatum can cause discitis in patients without any medical or surgical complications. The infection was successfully treated with anti-infective agents, providing empirical information on spinal infections.

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