STUDY DESIGN: A case report of spontaneous pyogenic spondylodiscitis and epidural abscess in vertebral fracture by an uncommon pathogen is described. OBJECTIVE: The uncommon presentation of spondylodiscitis with epidural abscess due to Gemella morbillorum after an acute lumbar vertebral fracture treated conservatively is discussed. SUMMARY OF BACKGROUND DATA: Spontaneous spondylodiscitis and epidural abscess in nonsurgical fractures is exceptionally rare. To date its colonization with Gemella morbillorum is not described in the literature. Its resistance to penicillin is also uncommon. METHODS: Diagnosis was based on clinical history, hemocultures, samples from CT-scan guided punction and, supported by magnetic resonance imaging. RESULTS: Clinical and radiologic improvement were observed after treatment based on a combined specific antimicrobial therapy and surgical drainage of epidural abscess. CONCLUSION: Spondylodiscitis and epidural abscess secondary to an acute nonsurgical vertebral fracture are rare manifestations. Microbiology and MRI are vital components in diagnosis. An emergency decompression and appropriate antibiotic regimen is the solution for a favorable outcome.
STUDY DESIGN: A case report of spontaneous pyogenic spondylodiscitis and epidural abscess in vertebral fracture by an uncommon pathogen is described. OBJECTIVE: The uncommon presentation of spondylodiscitis with epidural abscess due to Gemella morbillorum after an acute lumbar vertebral fracture treated conservatively is discussed. SUMMARY OF BACKGROUND DATA: Spontaneous spondylodiscitis and epidural abscess in nonsurgical fractures is exceptionally rare. To date its colonization with Gemella morbillorum is not described in the literature. Its resistance to penicillin is also uncommon. METHODS: Diagnosis was based on clinical history, hemocultures, samples from CT-scan guided punction and, supported by magnetic resonance imaging. RESULTS: Clinical and radiologic improvement were observed after treatment based on a combined specific antimicrobial therapy and surgical drainage of epidural abscess. CONCLUSION:Spondylodiscitis and epidural abscess secondary to an acute nonsurgical vertebral fracture are rare manifestations. Microbiology and MRI are vital components in diagnosis. An emergency decompression and appropriate antibiotic regimen is the solution for a favorable outcome.