Cervical anaerobic vertebral osteomyelitis following surgical tracheotomy: a case report

BMC Infect Dis. 2019 Jul 22;19(1):648. doi: 10.1186/s12879-019-4291-x.

Abstract

Background: We report a rare case of anaerobic vertebral osteomyelitis associated with surgical tracheotomy which has never been reported to the best of our knowledge.

Case presentation: A healthy 39-year-old man was admitted to intensive care for a severe brain trauma injury where a surgical tracheotomy was performed. He was discharged to a rehabilitation centre after 54 days hospital stay. During rehabilitation, he developed progressive and febrile tetraplegia associated with cervical pain, requiring an intensive care readmission. A polymicrobial anaerobic bloodstream infection was revealed and magnetic resonance imaging diagnosed cervical vertebral osteomyelitis. Both the type of anaerobic micro-organisms found and the timing of the symptoms strongly suggest that the surgical tracheotomy was responsible for this rare case of cervical vertebral osteomyelitis. The patient was successfully treated by a prolonged antimicrobial therapy and by surgical laminectomy.

Conclusions: Tracheotomy may generate anaerobic bacteraemia and related osteomyelitis in the specific setting of severe trauma patients. Clinicians should consider anaerobic vertebral osteomyelitis when they are confronted with a febrile tetraplegia after tracheotomy.

Keywords: Anaerobes; Anaerobic; Cervical vertebral osteomyelitis; Tracheostomy; Tracheotomy; Trauma patient, case report.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteria, Anaerobic / pathogenicity
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / microbiology
  • Brain Injuries, Traumatic / surgery
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / microbiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Osteomyelitis / diagnosis
  • Osteomyelitis / drug therapy
  • Osteomyelitis / microbiology*
  • Tracheotomy / adverse effects*

Substances

  • Anti-Bacterial Agents