A Pediatric Case of Vertebral Osteomyelitis Caused by Aggregatibacter aphrophilus: First to be Reported

Pediatric cases of pyogenic vertebral osteomyelitis are rare; therefore, identifying the causative organism and selecting appropriate antimicrobial therapy can be challenging. In this report, we present the first pediatric case of vertebral osteomyelitis caused by Aggregatibacter aphrophilus, identified in an 11-year-old Japanese boy. The patient, who had no history of dental procedures, presented with intermittent fever and lower back pain that persisted for 50 days. A. aphrophilus was identified by the 16S rRNA gene sequencing of cultures of intervertebral disc biopsies and repeated blood samples. The patient recovered without complications after six weeks of intravenous antibiotics and two weeks of oral therapy. No surgical intervention was needed. Furthermore, we reviewed this case in the context of 25 previously reported cases identified in the Medline database (1983-2025). This case report indicates that A. aphrophilus can cause invasive infection even in previously healthy children. Repeated sampling and 16S rRNA gene analysis can facilitate definitive diagnosis.