Mycoplasma hominis Lumbar Wound Infection After Posterior Decompression and Instrumented Fusion

A 63-year-old man underwent L2-S1 decompression and fusion for spinal stenosis. He developed urinary retention postoperatively requiring catheterization. He developed fever, purulence, and foot-drop 8 days postoperatively and underwent debridement with implant retention. Cultures yielded Mycoplasma hominis after 10 days. He received 4 weeks of doxycycline. Four years postoperatively, he had no recurrence of infection and was able to ambulate despite a persistent foot-drop. Mycoplasma hominis is a urogenital commensal rarely implicated in musculoskeletal infections. A high index of suspicion is required in spinal surgery patients who develop fever and purulence and have initial negative cultures and poor response to empirical antibiotics.