Late-onset Spinal Infection Caused by Parvimonas micra Following Spinal Instrumentation.

The aim of this study is to report on a unique case of a patient with a history of spinal instrumentation who developed an epidural abscess from Parvimonas micra without any overt risk factors. The incidence of spine-related procedures has increased in the last 15 years. However, several studies have found the rate of complications to be up to 26%, including delayed healing and cerebrospinal fluid leak. Other complications may include deep surgical site infections, which are typically caused by gram-positive cocci. We report on a case of a 77-year-old woman with a known history of spinal instrumentation who developed a delayed surgical site infection by P. micra, an anaerobic bacteria. The patient was admitted and underwent debridements along with removal of her hardware. Infectious disease was consulted and the patient was placed on an antibiotic regimen for 6 weeks. The patient required flap-based closure by plastic surgery and was eventually discharged to rehabilitation in good condition. We highlight the importance of managing patients with spinal infections with underlying hardware with broad-spectrum antibiotics along with prompt surgical intervention. Risk factors for P. micra infection may still be unknown.