Infection of Peptoniphilus harei with abscess formation followed by lumbar vertebroplasty

This paper reports the clinical and imaging findings of a patient with secondary psoas major muscle infection of Peptoniphilus harei (P harei) with abscess formation after lumbar vertebroplasty. A 65-year-old woman presented with low back pain with numbness in both lower limbs after lumbar vertebroplasty. CT and MRI examinations showed compressibility changes in the L1 vertebra with bone cement. The bone marrow of L1 and L2 vertebrae was edematous and enhanced significantly. Edema of L1/2 intervertebral disc and paravertebral space. Bilateral psoas muscle swelling, multiple abnormal signal foci can be seen, with obvious ring enhancement and cystic nonenhancement areas. The upper edge of the lesion was connected with the lateral edge of the L1 vertebra. The infection was diagnosed as P harei infection by gene detection and bacterial culture. After anti-infection and other related treatments, the infection was not improved, and the condition worsened, with secondary severe pneumonia and sepsis, and she finally died of septic shock.