lntraosseous and Intradiscal Gas in Association with Spinal Infection: Report of Three Cases

Although intradiscal gas (the vacuum phenomenon) is a reliable indicator of intervertebral osteochondrosis (or less
typically, spondylosis deformans) and intravertebral gas of ischemic necrosis of bone, gas formation within these
structures may on rare occasions indicate spinal infection. The combination of spinal infection and gas production is
documented in the literature in only a few case reports, specifically in association with Clostridia [2], brucellosis [1 ],
tuberculosis [3], and Peptococcus [6]. In the single patient with tuberculosis and the one with Peptococcus, the gaseous
collections were seen by CT, the technique that was used in our patients. Because CT is more sensitive than
conventional radiography in demonstrating vacuum phenomena [3], it is possible that the routine use of CT in cases of
spinal infection would document additional examples of gas formation.

AJR 147:83-86, July 1986

Anaerobic Endocarditis Caused by Staphylococcus saccharolyticus

Staphylococcus saccharolyticus is an anaerobic, gram positive coccus which is part of the bacterial skin flora (4). It was
previously known as
Peptococcus saccharolyticus, but oligonucleotide analysis of 16S rRNA has shown it to be,
instead, a member of the genus Staphylococcus (7). Aerobic staphylococci are a common cause of bacterial
endocarditis, while anaerobic bacteria only rarely give rise to this condition (6). There are no reports of anaerobic
staphylococcal endocarditis

The first case of infective endocarditis caused by the anaerobe Staphylococcus saccharolyticus is reported.
The infection occurred in a previously healthy 61-year-old male with no known predisposing valvular heart
disease. The patient was successfully treated with a combination of 2 g of nafcillin every 4 h and 90 mg of
gentamicin every 8 h for 6 weeks

Acute Pelvic Inflammatory Disease and Clinical Response to Parenteral Doxycycline  

The bacteriology of acute pelvic inflammatory disease (PID) and clinical response to parenteral doxycycline were
evaluated in 30 patients. Only 3 of 21 cul-de-sac cultures from PID patients were sterile, whereas all 8 normal control
subjects yielded negative results (P< 0.005). Poor correlation was observed between cervical and cul-de-sac cultures.
Neisseria gonorrhoeae, isolated from the cervix in 17 patients (57%), was recovered from the cul-de-sac only once.
Peptococcus, Peptostreptococcus, coliforms, and other organisms normally present in the vagina
were the predominant isolates recovered from the cul-de-sac. Parenteral doxycycline resulted in rapid resolution of
signs and symptoms (within 48 h) in 20 of 27 evaluable patients (74%). In five others, signs and symptoms of infection
abated within 4 days. The remaining two patients failed to respond; in both cases, adnexal masses developed during
doxycycline therapy. Gonococci were eradicated from the cervix in all but one patient who, nevertheless, had a rapid
defervescence of symptoms. There was no clear-cut correlation between the clinical response and in vitro susceptibility
of cul-de-sac isolates to doxycycline. These data confirm the usefulness of broad-spectrum antibiotics in acute PID.
Culdocentesis is a reliable means of obtaining material for the bacteriological diagnosis of acute PID; however, the
pathogenetic role and relative importance of gonococci and various other bacteria in acute PID need to be clarified
Antimicrob Agents Chemother. 1975 February; 7(2): 133–138.