From misdiagnosis to precision management: Thoracic vertebral infection caused by Scedosporium boydii diagnosed using a multi-platform approach - A case report and literature review.

Scedosporium boydii spinal infection is rare and often mimics tuberculosis. We report a 54-year-old immunocompetent man with post-traumatic thoracic vertebral infection initially misdiagnosed as spinal tuberculosis. A multi-platform approach combining culture, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), and targeted next-generation sequencing (tNGS) identified S. boydii. Surgical debridement and voriconazole resulted in complete recovery. A high index of suspicion and integrated diagnostics are essential to avoid mismanagement.