Diagnosis of primary Klebsiella pneumoniae in cervical spine by metagenomic sequencing

Spinal infection is a disease that affects the intervertebral discs or adjacent paravertebral tissue in the vertebral body. There are few reports of spinal infections caused by K. Pneumoniae. Cervical infection by K. Pneumoniae especially preoperative is extremely rare. Nowadays, metagenomic next-generation sequencing(mNGS) has led to the accurate and timely diagnoses of some infectious diseases. We describe a case of a 64-year-old woman, with a chief complaint of the neck, shoulder, and upper limb pain for 10 days. Patients with preoperative abscess compression symptoms, PCT CRP, and other inflammatory indicators significantly increase. In our patient imaging suggested infectious lesions, and the patient did not have a fever, fatigue, night sweating, and other tuberculosis poisoning symptoms. Also, tuberculosis-related blood samples were negative, so tuberculosis infection was not considered before the operation, and anti-infection treatment was mainly applied. The patient was successfully treated with operation and piperacillin and tazobactam.