Mycoplasma hominis vertebral spine infection: Case report and a review of infections of bone and joints

Background: Mycoplasma hominis (M. hominis) is a common commensal that colonizes the human urogenital tract, wherein it is also known to cause genito-urinary infections. It has rarely been reported to cause spinal infections. Case description: We describe the case of a 53-year old diabetic woman who developed spontaneous, culture-negative L3-4 osteomyelitis that progressed clinically and radiographically despite debridement, stabilization, and empiric broad-spectrum antimicrobial therapy. After her third debridement procedure, cultures of the multiple intraoperative specimens yielded M. hominis. Literature review: A PubMed search identified a total of 4 reports of M. hominis causing spinal osteomyelitis and 22 other cases involving bones and joints. Clinical relevance: M. hominis is a rare cause of bone and joint infections. Because of low clinical suspicion for this pathogen, combined with its fastidious nature and the difficult growth characteristics of this organism, M. hominis infections may be unrecognized and untreated, resulting in high morbidity. In addition to bacterial culture, molecular tests are available to detect M. hominis in clinical samples. This case report and review of the literature suggest that, in some cases of purulent culture-negative osteomyelitis, especially if not responding to standard empiric antibacterial therapy, M. hominis should be considered as a potential pathogen.