Back pain associated with lumbar disc herniation is a common musculoskeletal disorder that leads to absence at work place worldwide. Studies have proven in addition to the traditional factors, microbes play a role in ...Back pain associated with lumbar disc herniation is a common musculoskeletal disorder that leads to absence at work place worldwide. Studies have proven in addition to the traditional factors, microbes play a role in disc herniation causing chronic back pain. A 34-year-old male who has not involved in any traumatic work but has a family history of disc herniation presented with lower back pain and numbness in his right leg. He had previously undergone lumbar discectomy at L4/L5 ten years back. Magnetic Resonance Imaging (MRI) showed L5/S1 right para central disc herniation impinging on the right S1 and S2 nerve roots. Standard protocols for disinfection of instruments, external skin and all transport media were adhered. Skin scrapings, muscle biopsy and excised disc tissue were obtained for anaerobic and aerobic bacterial cultures. Anaerobic microbial cultures of excised disc tissue following lumbar discectomy showed Gram positive growth. Further anaerobic isolation carried out using RapID ANA ID kit confirmed the growth as Gemella morbillorum. In addition, neither of the control samples (muscle nor skin) had any anaerobic growth indicating the absence of contamination. Aerobic bacterial growth was not present in the skin, muscles and disc cultures. The study findings add to the available literature, on the role of microorganisms in lumbar disc herniation and future treatment regimens with antibiotics.展开更多
Gemella morbillorum (G. morbillorum) is an opportunistic bacterium, which can sometimes cause severe infections especially in immunocompromised subjects. Respiratory infections due to this germ are rare, but are descr...Gemella morbillorum (G. morbillorum) is an opportunistic bacterium, which can sometimes cause severe infections especially in immunocompromised subjects. Respiratory infections due to this germ are rare, but are described. We reported a new observation of 34-year-old female patient, admitted for unusual location and clinical presentation of respiratory infection with G. morbillorum;she was presented a left pleuritic pain, a productive cough associated with purulent and foul sputum and dyspnea with onset one month earlier. The clinical examination was objectified a polypnea at 32 cycles/minutes, intercostal indrawing and mixed pleural effusion syndrome. She had also many dental caries and bad oral health status. Chest radiography showed an air-fluid image in the left chest and the thoracocentesis had revealed purulent fluid. The culture of this fluid had isolated a G. morbillorum. The diagnosis of mixed pleural effusion due to G. morbillorum in an immunosuppressed diabetic patient was made. The patient was put on antibiotics, thoracic drainage and Chest physiotherapy with good improvement.展开更多
Apart from the conventional factors, recent evidences have suggested that lumbar disc herniation (LDH) is also associated with microbes, which is completely ignored in the management of patients with disc prolapse and...Apart from the conventional factors, recent evidences have suggested that lumbar disc herniation (LDH) is also associated with microbes, which is completely ignored in the management of patients with disc prolapse and disc degeneration. Therefore, the present study was carried out to identify the different microorganisms in subjects with LDH. Subjects (n = 101) who were confirmed for LDH with Magnetic Resonance Imaging and undergoing lumbar discectomy, were recruited in this study. Standard protocols for disinfection of the skin and surgical instruments were adhered. Skin scrapings, muscle biopsies and portion of the inter-vertebral disc were transferred into individually labeled Robertson’s cooked meat enrichment broth for anaerobic identification. Remaining portions of the excised disc material and muscle biopsy were taken for aerobic identification. Anaerobic isolates were identified using Gram stain and catalase test while the species identification was done by RapID ANA II ID kit. Gram stain, catalase test, DNase test and coagulase tests were used for identification of aerobic bacteria. Study confirmed 6/101 disc cultures (6%) with positive anaerobes and 12 disc cultures with coagulase negative Staphylococci spp. Among the anaerobes, two disc cultures were identified as Propionibacterium acnes and one as Gemella morbillorum. Due to slow growth, other three anaerobic cultures were not confirmed. However, they resembled the colony morphology of Gram positive bacilli. None of the control samples (skin and muscles) had any positive growth. The present study adds to the literature confirming the role of microorganisms in LDH. Present study newly identified Gemella morbillorum in the intervertebral tissue in addition to the previously reported microorganisms associated with LDH.展开更多
文摘Back pain associated with lumbar disc herniation is a common musculoskeletal disorder that leads to absence at work place worldwide. Studies have proven in addition to the traditional factors, microbes play a role in disc herniation causing chronic back pain. A 34-year-old male who has not involved in any traumatic work but has a family history of disc herniation presented with lower back pain and numbness in his right leg. He had previously undergone lumbar discectomy at L4/L5 ten years back. Magnetic Resonance Imaging (MRI) showed L5/S1 right para central disc herniation impinging on the right S1 and S2 nerve roots. Standard protocols for disinfection of instruments, external skin and all transport media were adhered. Skin scrapings, muscle biopsy and excised disc tissue were obtained for anaerobic and aerobic bacterial cultures. Anaerobic microbial cultures of excised disc tissue following lumbar discectomy showed Gram positive growth. Further anaerobic isolation carried out using RapID ANA ID kit confirmed the growth as Gemella morbillorum. In addition, neither of the control samples (muscle nor skin) had any anaerobic growth indicating the absence of contamination. Aerobic bacterial growth was not present in the skin, muscles and disc cultures. The study findings add to the available literature, on the role of microorganisms in lumbar disc herniation and future treatment regimens with antibiotics.
文摘Gemella morbillorum (G. morbillorum) is an opportunistic bacterium, which can sometimes cause severe infections especially in immunocompromised subjects. Respiratory infections due to this germ are rare, but are described. We reported a new observation of 34-year-old female patient, admitted for unusual location and clinical presentation of respiratory infection with G. morbillorum;she was presented a left pleuritic pain, a productive cough associated with purulent and foul sputum and dyspnea with onset one month earlier. The clinical examination was objectified a polypnea at 32 cycles/minutes, intercostal indrawing and mixed pleural effusion syndrome. She had also many dental caries and bad oral health status. Chest radiography showed an air-fluid image in the left chest and the thoracocentesis had revealed purulent fluid. The culture of this fluid had isolated a G. morbillorum. The diagnosis of mixed pleural effusion due to G. morbillorum in an immunosuppressed diabetic patient was made. The patient was put on antibiotics, thoracic drainage and Chest physiotherapy with good improvement.
文摘Apart from the conventional factors, recent evidences have suggested that lumbar disc herniation (LDH) is also associated with microbes, which is completely ignored in the management of patients with disc prolapse and disc degeneration. Therefore, the present study was carried out to identify the different microorganisms in subjects with LDH. Subjects (n = 101) who were confirmed for LDH with Magnetic Resonance Imaging and undergoing lumbar discectomy, were recruited in this study. Standard protocols for disinfection of the skin and surgical instruments were adhered. Skin scrapings, muscle biopsies and portion of the inter-vertebral disc were transferred into individually labeled Robertson’s cooked meat enrichment broth for anaerobic identification. Remaining portions of the excised disc material and muscle biopsy were taken for aerobic identification. Anaerobic isolates were identified using Gram stain and catalase test while the species identification was done by RapID ANA II ID kit. Gram stain, catalase test, DNase test and coagulase tests were used for identification of aerobic bacteria. Study confirmed 6/101 disc cultures (6%) with positive anaerobes and 12 disc cultures with coagulase negative Staphylococci spp. Among the anaerobes, two disc cultures were identified as Propionibacterium acnes and one as Gemella morbillorum. Due to slow growth, other three anaerobic cultures were not confirmed. However, they resembled the colony morphology of Gram positive bacilli. None of the control samples (skin and muscles) had any positive growth. The present study adds to the literature confirming the role of microorganisms in LDH. Present study newly identified Gemella morbillorum in the intervertebral tissue in addition to the previously reported microorganisms associated with LDH.
