# Pathological Thoracic Vertebral Fractures Secondary to Achromobacter denitrificans: A Case Report

## TL;DR

This case report describes a rare instance of a spinal fracture caused by a bacterial infection, highlighting the importance of early diagnosis to prevent severe outcomes.

## Contribution

The paper presents a rare case of a thoracic vertebral fracture caused by Achromobacter denitrificans, emphasizing the need for early biopsy and culture in similar cases.

## Key findings

- Pathological vertebral fractures can be caused by infections like Achromobacter denitrificans.
- Early biopsy and culture are crucial for diagnosing such cases due to non-specific symptoms.
- Delayed diagnosis is associated with high morbidity and mortality.

## Abstract

Vertebral fractures remain a diagnostic challenge nowadays. The first and most common diagnosis needed to be ruled out is osteoporosis. Other diagnoses to rule out involve pathological fractures. Pathological fractures are a group of pathologies that result in a spine fracture as part of an underlying disease process that affects the spine. This group includes Paget’s disease, tumors, osteomyelitis, and vertebral compression fractures. Fractures secondary to vertebral osteomyelitis are presented as collapsed vertebral bodies secondary to bone destruction and the formation of lytic lesions. Clinical presentation includes severe back pain refractory to analgesic therapy, persistent unexplained fever, and leukocytosis without any other obvious focus of infection. In cases like the one presented here, early biopsy and culture should be performed on every patient that fits these criteria. However, as it presents unspecific symptoms most of the time, it is not suspected, and therefore it is associated with high morbidity and mortality.