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Published on: November 8, 2024
Acute haematogenous infection of a closed vertebral fracture
Laurence A G Marshman1, Dale Allison, Cynthia J Molloy
1Department of Neurosurgery, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia. l.a.g.marshman@btinternet.com
Abstract:
Acute haematogenous infection of a closed fractures is rare. A 68-year-old diabetic male sustained a burst fracture of a lumbar vertebra (L2) after a fall onto his back. After 5 days of conservative management, he developed a chest infection and amoxicillin was commenced empirically. However, after 6 days his previously moderate focal L2 back pain had become more severe. Pyrexia and systemic inflammatory markers continued to rise despite administration of antibiotics. Blood cultures and a CT-guided biopsy of L2 both revealed Staphylococcus aureus which was sensitive to flucloxacillin. The patient's symptoms and signs gradually normalised following administration of flucloxacillin for 6 weeks, and the use of a cast brace. We conclude that haematogenous infection can be successfully managed non-operatively.
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