Community acquired Stenotrophomonas maltophilia discitis: Diagnosis aided by shotgun metagenomic sequencing

Int J Infect Dis. 2019 Apr:81:1-3. doi: 10.1016/j.ijid.2019.01.032. Epub 2019 Jan 23.

Abstract

We report a rare case of culture negative L4-L5 discitis and epidural abscess in an immunocompetent child who had dry cupping therapy performed to treat low back strain. The causative pathogen was identified as Stenotrophomonas maltophilia by shotgun metagenomic sequencing of spinal cord aspirate after more than one month of unsuccessful empirical treatment with 6 different antibiotics. The patient was successfully treated with Sulfamethoxazole-trimethoprim and minocycline. Cupping therapy is a very popular medical procedure widely used in China, but the potential risk for severe infections such as discitis and epidural abscess described in this case should be recognized.

Keywords: Discitis; Dry cupping therapy; Epidural abscess; Shotgun metagenomic sequencing; Stenotrophomonas maltophilia.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / microbiology*
  • Discitis / diagnosis
  • Discitis / microbiology*
  • Female
  • Gram-Negative Bacterial Infections / diagnosis*
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / microbiology*
  • Humans
  • Metagenomics*
  • Stenotrophomonas maltophilia / genetics*
  • Stenotrophomonas maltophilia / isolation & purification

Substances

  • Anti-Bacterial Agents