Cervical anaerobic vertebral osteomyelitis following surgical tracheotomy: a case report

Romaric Larcher 1, 2, 3, * Camille Maury 4 Jonathan Charbit 4 Hélène Jean-Pierre 5 Vincent Le Moing 6 Kada Klouche 1 Xavier Capdevila 4, 7
* Corresponding author
1 Intensive Care Medicine Department [Montpellier]
2 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
3 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
4 Intensive Care Unit [Montpellier]
5 Bacteriology Department [Montpellier]
Hôpital Arnaud de Villeneuve
6 Tropical and Infectious Diseases Department [Montpellier]
7 INM - Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs
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 : case report Tracheostomy Tracheotomy Anaerobic Trauma patient Anaerobes Cervical vertebral osteomyelitis
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Romaric Larcher, Camille Maury, Jonathan Charbit, Hélène Jean-Pierre, Vincent Le Moing, et al.. Cervical anaerobic vertebral osteomyelitis following surgical tracheotomy: a case report. BMC Infectious Diseases, BioMed Central, 2019, 19 (1), pp.648. ⟨10.1186/s12879-019-4291-x⟩. ⟨inserm-02283134⟩

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