Aerococcus urinae: an underestimated cause of spine infection? Case report and review of the literature.

Objective and Importance: New methods of microbiology identification as MALDI-TOF MS increased the rate of Aerococci detection in microbiological samples making this germ an emerging pathogen. The purpose of this case report and literature review is to highlight the role of A. urinae in spine infection and discuss the management of this type of infection.
Clinical Presentation and Intervention: A 32-year-old man, with a medical history of paraplegia secondary to a relapsing form of multiple sclerosis, was admitted because of lower back-pain following complaints suggestive of urinary tract infection. Spondilodiscitis was diagnosed and Aerococcus urinae was identified from bone culture. The patient improved after surgery and appropriate antibiotherapy.
Conclusion: A. urinae is currently more frequently identified since the introduction of MALDI-TOF MS in routine laboratories. Serious infections as endocarditis, bacteremia and spondylodiscitis have been reported usually in patients with predisposing conditions. This pathogen can be successfully treated with β-lactam antibiotics which can be replaced by vancomycin in case of penicillin allergy.