Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2024; 12(12): 2099-2108
Published online Apr 26, 2024. doi: 10.12998/wjcc.v12.i12.2099
Thoracic spine infection caused by Pseudomonas fluorescens: A case report and review of literature
Liang Li, Bao-Hua Zhang, Jin-Feng Cao, Li-Jin Zhang, Ling-Ling Guo
Liang Li, Li-Jin Zhang, Ling-Ling Guo, Department of Traditional Chinese Medicine, Zibo Central Hospital, Zibo 255000, Shandong Province, China
Bao-Hua Zhang, Department of Pathology, Zibo Central Hospital, Zibo 255000, Shandong Province, China
Jin-Feng Cao, Department of Medical Imaging, Zibo Central Hospital, Zibo 255000, Shandong Province, China
Author contributions: Guo LL was the doctor in charge, and provided detailed information on the patient; Guo LL and Li L wrote the manuscript; Zhang BH provided and modified the pathological data; Cao JF provided and modified the imaging data; Guo LL, Li L, Zhang BH and Zhang LJ jointly revised the manuscript; All authors read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and all accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Ling-Ling Guo, MM, Associate Chief Physician, Department of Traditional Chinese Medicine, Zibo Central Hospital, No. 54 Gong Qing Tuan West Road, Zhangdian District, Zibo 255000, Shandong Province, China.
Received: December 23, 2023
Peer-review started: December 24, 2023
First decision: January 20, 2024
Revised: February 3, 2024
Accepted: March 26, 2024
Article in press: March 26, 2024
Published online: April 26, 2024

The clinical incidence of spinal infection is gradually increasing, and its onset is insidious, easily leading to missed diagnosis and misdiagnosis, which may lead to serious complications such as nervous system dysfunction, spinal instability and/or deformity, and cause a huge burden on society and families. Early identification of the causative agent and precision medicine will greatly reduce the suffering of patients. At present, the main pathogenic bacteria that cause spinal infection are Staphylococcus aureus, Streptococcus, Pneumococcus, Escherichia coli, and Klebsiella. There are no reports of spinal infection caused by Pseudomonas fluorescens.


We report a 32-year-old female patient with spinal infection. She presented with flank pain, initially thought to be bone metastases or bone tuberculosis, and had a family background of tumors. Her clinical features and changes in imaging and laboratory tests led to the suspicion of thoracic spine infection. Histopathology of the lesion showed inflammation, tissue culture of the lesion was negative several times, and the possible pathogen - Pseudomonas fluorescens was found after gene sequencing of the lesion. The patient recovered completely after a full course of antibiotic treatment.


This report increases the range of pathogens involved in spinal infections, highlights the unique advantages of gene sequencing technology in difficult-to-diagnose diseases, and validates conservative treatment with a full course of antibiotics for spinal infections without complications.

Keywords: Thoracic spine infection, Pseudomonas fluorescens, Spinal infection, Case report

Core Tip: Vigilance regarding unexplained spinal infection is required. Detailed physical examination, puncture biopsy, pathological examination and genetic testing can play a very important role in clinical diagnosis. Needle biopsy and genetic testing are effective methods for identifying unexplained spinal infections, and appropriate antibiotic therapy with a full course of treatment is critical to prognosis. Due to the hidden nature of unexplained spinal infections, regular follow-up over a long period of time is recommended.