Lumbar Spine Infection with Eikenella corrodens Presented as Abdominal Pain: A Case Report and Literature Review

Abstract

Hanwen Cheng,1,* Ni Tan,2,* Yiwen Lu,3,* Haoyu Wu,1 Zhuojie Liu,1 Di Zhang,1 Zixin Xu,4 Chunhai Li1,5 1Department of Orthopaedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, People’s Republic of China; 2Cellular & Molecular Diagnostics Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China; 3Breast Cancer Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, People’s Republic of China; 4Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, People’s Republic of China; 5Teaching and Research Bureau of Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chunhai Li, Department of Orthopaedics, Sun Yat-sen Memorial Hospital, Sun Yat‐sen University, Guangzhou, Guangdong Province, 510000, People’s Republic of China, Tel [phone], Fax [phone], Email [email protected]: Eikenella corrodens is a part of the inherent flora on the surface of human mucosa. It usually does not cause disease unless the patient has been bitten, injured or surgically infected. Lumbar spine infection caused by Eikenella corrodens usually presents with conventional symptoms such as low back pain and fever. Herein, we report a case of lumbar intervertebral space infection with Eikenella corrodens presented as abdominal pain.Case Presentation: A 38-year-old man with no medical history of note presented with abdominal pain. Initially, local doctors suspected that the patient had abdominal disease. However, abdominal diseases were ruled out and only lumbar spine infection was confirmed. Then, the patient was misdiagnosed as lumbar tuberculosis. Finally, anaerobic culture and metagenomic next-generation sequencing confirmed the Eikenella corrodens, which was rarely involved in lumbar intervertebral space infection. The patient recovered after operation and antibiotic therapy.Conclusion: This case indicated a rare symptom of lumbar spine infection, abdominal cramping, which is caused by Eikenella corrodens. Blood culture had low sensitivity as a diagnostic method for Eikenella corrodens, but lesion sample culture or metagenomic next-generation sequencing had high sensitivity for early diagnosis.Keywords: non-specific spinal infection, lumbar intervertebral space infection, metagenomic next-generation sequencing, misdiagnosis

Keywords

• non-specific spinal infection
• lumbar intervertebral space infection
• metagenomic next-generation sequencing
• misdiagnosis