Corynebacterium striatum is Not Just a Contaminant: Experience with Antibiotic Treatment of Spondylodiscitis in an Immunocompetent Adult

Corynebacterium striatum is a commensal skin agent rarely described as a cause of infective spondylodiscitis. In this study, we report the first case of an infected patient who was successfully treated with conservative measures. A 54-year-old immunocompetent patient presented with progressive low back pain that had persisted for 1 month. Magnetic resonance imaging revealed abnormal signals in the L4-L5 vertebrae, indicating lumbar spine infection. Laboratory investigations revealed elevation of the serum C-reactive protein level and erythrocyte sedimentation rate. Blood and disc biopsy tissue cultures produced cream-colored round raised colonies on blood agar plates, which were identified as C. striatum using matrix-assisted laser desorption ionization time-of-flight mass spectrometry and 16S rRNA sequencing. Based on the antibiotic sensitivity test results, vancomycin and linezolid were sequentially administered to treat C. striatum infection; however, this strategy proved ineffective after 12 days. Despite delayed symptomatic treatment, the patient was successfully treated with a 2-week course of linezolid based on the use of amikacin to control other pathogens. C. striatum can cause discitis in patients without any medical or surgical complications. The infection was successfully treated with anti-infective agents, providing empirical information on spinal infections.