{"id":"ca3900e5-5f6b-4a4b-ae7f-875b22697273","slug":"stenotrophomonas-maltophilia-spondylodiscitis-following-lumbar-microdiscectomy-mimicking-a-cotton-granuloma-a-case-report-and-literature-review","title":"<i>Stenotrophomonas maltophilia</i> spondylodiscitis following lumbar microdiscectomy mimicking a cotton granuloma: A case report and literature review","authors":["Nitin Maruti Adsul","Vishnu Panigrahi","Shankar Acharya","K. L. Kalra","R. S. Chahal"],"abstract":"Background: Vertebral osteomyelitis caused by Stenotrophomonas maltophilia is very rare. There are only two cases reported in literature. Here, we present a 48-year-old immunocompetent male who, following a lumbar microdiscectomy, developed postoperative spondylodiscitis due to S. maltophilia that mimicked a cotton granuloma. Case Report: Two months ago, a 48-year-old male underwent a lumbar L4-L5 microdiscectomy, he newly presented with the left thigh and leg pain of 4 weeks duration. Laboratory studies revealed a CRP of 26 mg/l, an ESR of 6 mm (1st h), and total leukocyte count of 7.85 thousand/ul. The MRI T2 images showed a focal hyperintense lesion in the left lateral recesses at the L4-L5 level; the accompanying hypointense-smooth margin resembled a cotton granuloma. At surgery, we found a localized epidural collection of pus; S. maltophilia was isolated from the culture. His symptoms gradually improved, and symptoms fully resolved with 3 months of subsequent antibiotic therapy. Conclusion: S. maltophilia causing vertebral osteomyelitis is extremely rare and can sometimes mimic a cotton granuloma. MR diagnosis, surgical decompression, and obtaining cultures are requisite to direct appropriate antibiotic therapy.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/ca3900e5-5f6b-4a4b-ae7f-875b22697273/featured/hero-1781563599997.png","publishDate":"2020-02-25T00:00:00.000Z","doi":"10.25259/SNI_23_2020","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2020/02/9876/SNI-11-28.pdf"}