Infection of Peptoniphilus harei with abscess formation followed by lumbar vertebroplasty

Area of Science:

• Infectious Diseases
• Radiology
• Neurosurgery

Background:

• Lumbar vertebroplasty is a common procedure for spinal fractures.
• Secondary infections can occur post-vertebroplasty, posing significant risks.
• Psoas major muscle abscesses are uncommon but serious complications.

Observation:

• A 65-year-old woman developed low back pain and lower limb numbness post-lumbar vertebroplasty.
• Imaging revealed L1 vertebral changes, bone marrow edema, and bilateral psoas muscle swelling with abscess formation.
• Gene detection and bacterial culture identified Peptoniphilus harei as the causative agent.

Findings:

• Peptoniphilus harei infection led to a secondary psoas major muscle abscess.
• The infection was refractory to initial anti-infection treatments.
• The patient developed severe pneumonia, sepsis, and ultimately died of septic shock.

Implications:

• This case underscores the importance of considering rare pathogens like P. harei in post-vertebroplasty infections.
• Prompt and accurate diagnosis is crucial for effective management of spinal infections.
• Aggressive treatment strategies may be necessary for severe, refractory cases to prevent fatal outcomes.