Available online 6 September 2022, 102637

Bacteroides fragilis is an extremely rare cause of vertebral osteomyelitis.

In case without any clinical improvement, anaerobe bacteria should be sought.

Anaerobes maybe the cause in patients with prior medical interventions.

Procedures in the gastrointestinal tract/the pelvis are predisposing factors.

Acute pyogenic vertebral osteomyelitis is mainly attributed to hematogenous spread of aerobic bacteria, while anaerobic osteomyelitis results from contiguous spread of polymicrobial infections through breaks in the gut mucosal barrier and involves the vertebral bodies in only about 2%–5%. Herein, we report two cases of vertebral osteomyelitis due to Bacteroides fragilis. It is noteworthy that cases of vertebral osteomyelitis due to Bacteroides fragilis have been attributed to the extension of intra-abdominal or pelvic floor infections. However, in the two cases described, there was no history of a previous medical intervention nor an intestinal or pelvic floor infection. Early recognition of the aetiological agent that causes vertebral osteomyelitis may lead to the timely treatment and therefore, may deter any neurosurgical/orthopaedic interventions.

Vertebral osteomyelitis

Bacteroides fragilis

Anaerobe

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