Prevotella osteomyelitis after dental capping procedure.

Area of Science:

• Infectious Diseases
• Orthopedics
• Dentistry

Background:

• Vertebral osteomyelitis is a serious infection of the spine.
• Psoas muscle abscesses can be a complication of vertebral osteomyelitis.
• Hematogenous spread is a common route for vertebral osteomyelitis.

Purpose of the Study:

• To report a rare case of vertebral osteomyelitis secondary to dental procedures.
• To highlight the diagnostic challenges and management of spinal infections.
• To discuss the potential for oral bacteria to cause distant infections.

Main Methods:

• Case report of a 49-year-old male patient.
• Clinical presentation with severe lower back pain and psoas abscess.
• Diagnostic workup including MRI of the lumbar spine and bone biopsy.
• Microbiological analysis of bone biopsy cultures.

Main Results:

• MRI revealed L2 vertebral body edema and L1 cortical erosion.
• Bone biopsy showed neutrophilic invasion.
• Cultures identified Prevotella oralis as the causative organism.
• Patient had recent dental composite bonding for exposed tooth roots.

Conclusions:

• Hematogenous spread from dental procedures is a plausible source of vertebral osteomyelitis.
• Prevotella oralis, an oral anaerobe, can cause severe bone infections.
• Early and accurate diagnosis is crucial for effective management of vertebral osteomyelitis.