Burkholderia cepacia Vertebral Osteomyelitis Following Cesarean Section: Case Report and Review of the Literature
DOI:
https://doi.org/10.54034/mic.e1859Keywords:
burkholderia cepacia complex, vertebral osteomyelitis, spondylodiscitis, postpartum, cesarean sectionAbstract
The Burkholderia cepacia complex (Bcc) initially emerged as an important opportunistic pathogen in patients with predisposing lung disease. Bcc infections outside the respiratory tract are less common, although their incidence has been increasing particularly in immunocompromised patients. We herein describe the case of a healthy young woman who started experiencing low back pain 2 weeks after an uncomplicated cesarean section. She was found to have vertebral osteomyelitis at T12-L1. CT guided biopsy was performed, and cultures grew Bcc. She was treated with 3 weeks of meropenem and 5 weeks of oral trimethoprim-sulfamethoxazole with good response. No surgical intervention was warranted. We also performed a review of the literature on other existing reports. To the best of our knowledge, this is the first case of Bcc vertebral osteomyelitis in an immunocompetent patient following an obstetric procedure.
Metrics
References
Burkholder W. Sour skin, a bacterial rot of onion bulbs. Phytopathology. 1950;40:115-8.
Ranjan R, Chowdhary P, Kamra A. Community Acquired Burkholderia cepacia Bacteraemia Presenting as MODS in an Immunocompetent Individual: An Unusual Case. J Clin Diagn Res. 2017;11(3):DD01-DD2.
Yang BH, Lee MS, Lee J-H, Lee H-J. Pyogenic Spondylitis in a Healthy Adult Caused by Burkholderia cepacia. Infect Chemother. 2008;40(4):233-6.
Frost F, Shaw M, Nazareth D. Antibiotic therapy for chronic infection with Burkholderia cepacia complex in people with cystic fibrosis. Cochrane Database Syst Rev. 2019;6(6): CD013079.
Tavares M, Kozak M, Balola A, Sa-Correia I. Burkholderia cepacia Complex Bacteria: a Feared Contamination Risk in Water-Based Pharmaceutical Products. Clin Microbiol Rev. 2020;33(3).
Cosma S, Borella F, Carosso A, Ingala A, Fassio F, Robba T, et al. Osteomyelitis of the pubic symphysis caused by methicillin-resistant Staphylococcus aureus after vaginal delivery: a case report and literature review. BMC Infect Dis. 2019;19(1):952.
Lawford AM, Scott K, Lust K. A case of massive vulvar oedema due to septic pubic symphysitis complicating pregnancy. Aust N Z J Obstet Gynaecol. 2010;50(6):576-7.
Lee KS, Kong S, Kim J, Kim T, Choi CB, Kim YS, et al. Osteomyelitis of Bilateral Femoral Heads After Childbirth: A Case Report. Ann Rehabil Med. 2015;39(3):498-503.
Lee R, How E. Postpartum haematogenous osteomyelitis of the tibia: A case report and review of literature. Internet J Orthop Surg. 2009;18(1).
Hermet M, Minichiello E, Flipo RM, Dubost JJ, Allanore Y, Ziza JM, et al. Infectious sacroiliitis: a retrospective, multicentre study of 39 adults. BMC Infect Dis. 2012;12:305.
Nutcharoen AA, Salih AA, Volio A, Skolaris A, Ayad S. Suspected Septic Sacroiliitis Following Recent Cesarean Section Under Spinal Anesthesia. Cureus. 2020;12(6): e8891.
Jaafar D, Rizkallah M, Atallah F, Bachour F, Barakat A, Maalouf G, et al. Lumbar Spondylodiscitis Caused by Burkholderia cepacia in a Previously Healthy Patient. Case Rep Orthop. 2017;2017:1396950.
Sfeir MM. Burkholderia cepacia complex infections: More complex than the bacterium name suggest. J Infect. 2018;77(3):166-70.
Whitby PW, Pope LC, Carter KB, LiPuma JJ, Stull TL. Species-specific PCR as a tool for the identification of Burkholderia gladioli. J Clin Microbiol. 2000;38(1):282-5.
Kulkarni P, Elangoven IM, Jaykanth A, Simon S. Incremental Value of Three-Phase Bone Scintigraphy and Single-Photon Emission Computed Tomography-Computed Tomography in a Case of Postpartum PUO in the Wake of The Antibiotic-Resistance Era. Indian J Nucl Med. 2021;36(1):62-5.
Simpfendorfer CS. Radiologic Approach to Musculoskeletal Infections. Infect Dis Clin North Am. 2017;31(2):299-324.
Avgeri SG, Matthaiou DK, Dimopoulos G, Grammatikos AP, Falagas ME. Therapeutic options for Burkholderia cepacia infections beyond co-trimoxazole: a systematic review of the clinical evidence. Int J Antimicrob Agents. 2009;33(5):394-404.
Thabit AK, Fatani DF, Bamakhrama MS, Barnawi OA, Basudan LO, Alhejaili SF. Antibiotic penetration into bone and joints: An updated review. Int J Infect Dis. 2019;81:128-36.
Weinstein L, Knowlton CA, Smith MA. Cervical osteomyelitis caused by Burkholderia cepacia after rhinoplasty. J Infect Dev Ctries. 2008;2(1):76-7.
Subramanian R, Fitzgibbons L. Burkholderia cepacia Complex Lumbar Spondylodiscitis: A Rare Nosocomial Infection. Case Rep Infect Dis. 2022;2022:4378442.
Hammoud M, Fares Y, Atoui R, Dabboucy B. Burkholderia cepacia as a cause of pyogenic spondylodiscitis in immunocompetent patients: a single-institution case series and literature review. J Spine Surg. 2019;5(3):372-7.
Rodriguez M, Nelson M, Kelly JE, Elward A, Morley SC. Successful Use of Temocillin as Salvage Therapy for Cervical Osteomyelitis Secondary to Multidrug-Resistant Burkholderia cepacia. J Pediatric Infect Dis Soc. 2014;3(1):77-80.
Hsieh CT, Hsu SK, Chang CJ. Thoracic vertebral osteomyelitis caused by Burkholderia cepacia in an immunocompetent adult. Surg Infect (Larchmt). 2013;14(5):476-9.
Chang WS, Ho MW, Lin PC, Ho CM, Chou CH, Lu MC, et al. Clinical characteristics, treatments, and outcomes of hematogenous pyogenic vertebral osteomyelitis, 12-year experience from a tertiary hospital in central Taiwan. J Microbiol Immunol Infect. 2018;51(2):235-42.
Li SK, Messer WB. Burkholderia cepacia complex Cervical Osteomyelitis in an Intravenous Drug User. Case Rep Infect Dis. 2018;2018:7638639.
Kwayess R, Al Hariri HE, Hindy JR, Youssef N, Haddad SF, Kanj SS. Burkholderia cepacia Infections at Sites Other than the Respiratory Tract: A Large Case Series from a Tertiary Referral Hospital in Lebanon. J Epidemiol Glob Health. 2022;12(3):274-80.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Suha Kalash , Zeina A. Kanafani

This work is licensed under a Creative Commons Attribution 4.0 International License.