Campylobacter fetus spondylodiscitis in a patient with HIV infection and restored CD4 count

BMJ Case Reports
Dorien LaenensPeter Messiaen

Abstract

Campylobacter fetus (C. fetus) is a rare condition and mostly seen in elderly or immunocompromised patients. We present the first case of C. fetus spondylodiscitis in a virologically suppressed HIV seropositive patient with low back pain. MRI was performed and showed spondylodiscitis of the L4-L5 region. Empirical antibiotic therapy with flucloxacillin was started after blood cultures were drawn and an image-guided disc biopsy was performed. Blood cultures remained negative. The anaerobic culture of the puncture biopsy of the disc revealed presence of C. fetus after which the antibiotic treatment was switched to ceftriaxone. Guided by the susceptibility results, the therapy was switched to ciprofloxacin orally for 6 weeks after which the patient made full clinical, biochemical and radiographic recovery. Since no other immune-deficient conditions were noted, it is important to highlight that patients with HIV infection with restored CD4 counts and complete virological suppression can still be susceptible for infections caused by rare pathogens. Low back pain should raise suspicion for these conditions and should be examined properly.

References

Nov 14, 2007·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·L GazaigneP Lesprit
Sep 21, 2010·Scandinavian Journal of Infectious Diseases·Inge Kristine LarsenHenrik Nielsen
Feb 20, 2014·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jaap A WagenaarJos P M van Putten
Aug 1, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Elie F Berbari Infectious Diseases Society of America
Oct 12, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Xavier Marchand-SenécalChristiane Gaudreau

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