Postoperative Spine Infection - Postoperative MRSA Infection in a Wrongly Diagnosed Case of Spine Trauma.

Introduction: Pathological fractures resulting from trivial trauma may be overlooked, especially, when it is after a road traffic accident.

Case Report: A 56-year-old male was operated elsewhere for burst fracture L3 vertebra following a trivial road traffic accident. Due to the persistence of symptoms, he was reevaluated. Magnetic resonance imaging revealed infection at the operated site. The implants were removed, pus drained, and a transpedicular biopsy was taken from L3 vertebral body along with bone marrow aspirate from the iliac crest, suspecting a pathological fracture. He was diagnosed to have multiple myeloma and was treated in consultation with medical oncology department. His spine was stabilized 6 weeks later when the infection healed. He was further treated at the medical oncology department for multiple myeloma. Then, he developed infection again and underwent implant removal and wound debridement. 3 weeks later, he developed electrolyte imbalance and infection and succumbed to the disease.

Conclusion: Pathological fracture should be suspected in fractures resulting from trivial trauma. Multiple myeloma patients have a higher chance of infection with MRSA. With chemotherapy, the immunity goes further down resulting in florid infection.