Clinical Note: Pseudomonas aeruginosa osteomyelitis of the cervical spine

Non-tuberculous pyogenic spinal osteomyelitis compromise only 2-4% of all cases of osteomyelitis. The incidence is estimated at 1:250,000 per year in the general population. Cervical involvement is observed in less than 10% of the cases of spinal osteomyelitis. Pyogenic spinal osteomyelitis is usually caused by gram positive pyogens like Staphylococci and Streptococci species. They are usually seen in immuno-compromised patients or intravenous drug users. They frequently pose diagnostic and therapeutic challenges for the internists, radiologists, and surgeons. Pseudomonas aeruginosa (P. aeruginosa) are gram-negative bacilli that rarely cause osteomyelitis. It usually affects immuno-compromised or hospitalized patients on long-term antibiotic therapy for other conditions. Only a few short series and case reports in the literature described spinal osteomyelitis secondary to Pseudomonas species including aeruginosa. The vast majority of these cases were reported in immuno-compromised patients. We present in this report a rare case of vertebral osteomyelitis of the cervical spine caused by P. aeruginosa infection.