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Case Reports
. 2018 Sep-Oct;8(5):54-56.
doi: 10.13107/jocr.2250-0685.1210.

Postoperative Spine Infection - Postoperative MRSA Infection in a Wrongly Diagnosed Case of Spine Trauma

Suresh Pillai  1
Affiliations
Case Reports

Postoperative Spine Infection - Postoperative MRSA Infection in a Wrongly Diagnosed Case of Spine Trauma

Suresh Pillai. J Orthop Case Rep. 2018 Sep-Oct.

Abstract

Introduction: Pathological fractures resulting from trivial trauma may be overlooked, especially, when it is after a road traffic accident.

Case report: A 56-year-old male was operated elsewhere for burst fracture L3 vertebra following a trivial road traffic accident. Due to the persistence of symptoms, he was reevaluated. Magnetic resonance imaging revealed infection at the operated site. The implants were removed, pus drained, and a transpedicular biopsy was taken from L3 vertebral body along with bone marrow aspirate from the iliac crest, suspecting a pathological fracture. He was diagnosed to have multiple myeloma and was treated in consultation with medical oncology department. His spine was stabilized 6 weeks later when the infection healed. He was further treated at the medical oncology department for multiple myeloma. Then, he developed infection again and underwent implant removal and wound debridement. 3 weeks later, he developed electrolyte imbalance and infection and succumbed to the disease.

Conclusion: Pathological fracture should be suspected in fractures resulting from trivial trauma. Multiple myeloma patients have a higher chance of infection with MRSA. With chemotherapy, the immunity goes further down resulting in florid infection.

Keywords: Implant loosening; MRSA; Multiple myeloma; Pathological fracture.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
X-ray lumbosacral spine lateral view showing previous fixation.
Figure 2
Figure 2
Punched out lesions in the skull.
Figure 3
Figure 3
Magnetic resonance imaging showing infection.
Figure 4
Figure 4
Magnetic resonance imaging T2 W image showing infection.
Figure 5
Figure 5
Pus at incision of the operated site.
Figure 6
Figure 6
?Wound after pus drainage and debridement.
Figure 7
Figure 7
Revision fixation after 6 weeks-A lateral view.
Figure 8
Figure 8
Revision fixation after 6 weeks- A Pview.
Figure 9
Figure 9
Removed implants after 8 months.
See this image and copyright information in PMC

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