Cervical spine infection arising from chronic paronychia: A case report and review of literature

Background: Cervical spine pyogenic infection (CSPI) is a rare and challenging form of spinal infection that is typically caused by pyogenic bacteria and primarily affects the cervical vertebral bodies and surrounding tissues. Given its nonspecific symptoms, such as fever and neck pain, early diagnosis is crucial to prevent severe complications, including spinal cord injury. We report a previously unreported case of acute CSPI arising from chronic paronychia, exploring its diagnostic and therapeutic challenges through a review of the current literature.

Case summary: The presented case involved a 15-year-old man with CSPI caused by Staphylococcus aureus, which led to complications including bacteremia and a paronychia-associated abscess. Acute pyogenic infection was initially diagnosed by typical symptoms and blood culture. Fever improved after antibiotic treatment while developing progressive limbs dysfunction. Six days after admission, the patient underwent anterior cervical debridement + autogenous iliac bone graft fusion + plate internal fixation and received 12 weeks of antibiotic treatment after the operation. Re-examination 3 years postoperatively showed that the patient had stable cervical fixation, no significant neck pain or upper limb abnormalities, and normal urinary function.

Conclusion: Early imaging findings, laboratory markers, and timely antibiotic treatment are crucial for CSPI management, preventing complications and facilitating recovery.