{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:04:46Z","timestamp":1789535086566,"version":"build-2803163510"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    Percutaneous vertebroplasty-associated spinal infection is uncommon but may cause progressive vertebral destruction and can mimic tuberculous spondylitis on imaging. The detection of low-virulence skin commensals such as\n                    <jats:italic>Cutibacterium<\/jats:italic>\n                    species in deep specimens also creates a diagnostic challenge because contamination and true infection must be distinguished. We report a 78-year-old man who developed recurrent progressive low back pain shortly after percutaneous vertebroplasty for an L2 compression fracture. Baseline computed tomography (CT) and contrast-enhanced magnetic resonance imaging (MRI) showed destructive spondylodiscitis centered at L2\/3, with adjacent vertebral body and disc-space involvement, paravertebral inflammatory extension, and bilateral psoas abscess-like collections, initially suggesting tuberculous spondylitis. However, molecular testing for the\n                    <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                    complex and targeted sequencing for mycobacterial drug-resistance genes were negative, and histopathology demonstrated acute and chronic inflammatory necrotic changes without typical tuberculous granulomas. Metagenomic next-generation sequencing of aspirated fluid identified a high abundance of\n                    <jats:italic>Cutibacterium modestum<\/jats:italic>\n                    , which was subsequently detected again in lesion tissue and peripheral blood by targeted high-throughput sequencing. Given the repeated detection in deep-site specimens, exclusion of tuberculosis and other competing diagnoses, compatible clinical and imaging findings, and improvement after targeted antimicrobial therapy and percutaneous stabilization,\n                    <jats:italic>C. modestum<\/jats:italic>\n                    was considered the most probable causative pathogen. These findings suggest that pathogen attribution in post-vertebroplasty spinal infection should rely on integrated clinical, microbiological, pathological, and therapeutic evidence rather than on imaging findings alone. Integrated clinico-microbiological assessment may improve pathogen attribution for rare low-virulence organisms in postoperative spinal infection.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1905143","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:33:51Z","timestamp":1789533231000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-vertebroplasty lumbar spondylodiscitis due to Cutibacterium modestum"],"prefix":"10.3389","volume":"13","author":[{"given":"Liyang","family":"Wu","sequence":"first","affiliation":[{"name":"The Affiliated Yuebei People\u2019s Hospital of Shantou University Medical College","place":["Shaoguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongzhen","family":"Bao","sequence":"additional","affiliation":[{"name":"The Affiliated Yuebei People\u2019s Hospital of Shantou University Medical College","place":["Shaoguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahao","family":"Pu","sequence":"additional","affiliation":[{"name":"School of Basic Medical Sciences, Fujian Medical University, Fuzhou","place":["Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Affiliated Yuebei People\u2019s Hospital of Shantou University Medical College","place":["Shaoguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinshan","family":"Huang","sequence":"additional","affiliation":[{"name":"The Affiliated Yuebei People\u2019s Hospital of Shantou University Medical College","place":["Shaoguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinhua","family":"Xi","sequence":"additional","affiliation":[{"name":"The Affiliated Yuebei People\u2019s Hospital of Shantou University Medical College","place":["Shaoguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lincong","family":"Luo","sequence":"additional","affiliation":[{"name":"Yue Bei People\u2019s Hospital Postdoctoral Innovation Practice Base, Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1007\/s11657-018-0468-y","article-title":"Infection following percutaneous vertebral augmentation with polymethylmethacrylate","volume":"13","author":"Park","year":"2018","journal-title":"Arch Osteoporos"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1809","DOI":"10.1016\/j.spinee.2013.05.053","article-title":"Infection after vertebroplasty or kyphoplasty. 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