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Peer-reviewedCC BY 4.0Infection

Hematogenous vertebral osteomyelitis caused by vaginal microbiota: metagenomic resolution of a polymicrobial anaerobic case

  • Isabelle Vock1
  • Annika Bargetzi1
  • Maja Weisser1
  • Olivia Katharina Mueller2
  • Milena Junker2
  • Arne Mehrkens3
  • Claudio Neidhoefer4
  • Baptiste Hamelin5
  • Salome Hosch5
  • Kirsten D. Mertz5,6
  • Peter M. Keller4,6
  • Richard Kuehl1,6,7
7 affiliations
  1. 1Division of Infectious Diseases, University Hospital Basel, Basel, Switzerland
  2. 2Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
  3. 3Division of Spine Surgery, University Hospital Basel, Basel, Switzerland
  4. 4Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
  5. 5Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
  6. 6Center for Infection Diagnostics, University Hospital Basel, Basel, Switzerland
  7. 7Center for Musculoskeletal Infections, University Hospital Basel, Basel, Switzerland
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Abstract

We describe a rare case of a 35-year-old female patient suffering from polymicrobial hematogenous vertebral osteomyelitis caused by vaginal microbiota following sexual intercourse. Anaerobic blood cultures yielded Fannyhessea vaginae and Gemelliphila asaccharolytica, and intraoperative tissue cultures from decompression surgery identified Gardnerella vaginalis. Beyond Fannyhessea vaginae and Gemelliphila asaccharolytica, 16S rRNA gene Nanopore sequencing of surgical tissue also detected high amounts of Parvimonas parva, Peptostreptococcus anaerobius, Marseillibacter massiliensis, and Gemelliphila palaticanis. Antibiotic treatment with broad anaerobic coverage resulted in complete clinical resolution. Retrospective metagenomic analysis of a cervical swab obtained 9 months earlier revealed Fannyhessea vaginae and G. vaginalis to be already present in the vaginal microbiota. This case highlights the potential for hematogenous dissemination of vaginal anaerobes after sexual intercourse and underscores the diagnostic challenges posed by fastidious anaerobic bacteria. Molecular techniques are helpful tools in uncovering pathogens that may escape conventional culture methods.

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Cite

BibTeXRIS
BibTeX
@article{vock2026hematogenous,
  title = {{Hematogenous vertebral osteomyelitis caused by vaginal microbiota: metagenomic resolution of a polymicrobial anaerobic case}},
  author = {Isabelle Vock and Annika Bargetzi and Maja Weisser and Olivia Katharina Mueller and Milena Junker and Arne Mehrkens and Claudio Neidhoefer and Baptiste Hamelin and Salome Hosch and Kirsten D. Mertz and Peter M. Keller and Richard Kuehl},
  journal = {Infection},
  year = {2026},
  month = aug,
  doi = {10.1007/s15010-026-02926-4},
  url = {https://doi.org/10.1007/s15010-026-02926-4},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Hematogenous vertebral osteomyelitis caused by vaginal microbiota: metagenomic resolution of a polymicrobial anaerobic case
AU  - Isabelle Vock
AU  - Annika Bargetzi
AU  - Maja Weisser
AU  - Olivia Katharina Mueller
AU  - Milena Junker
AU  - Arne Mehrkens
AU  - Claudio Neidhoefer
AU  - Baptiste Hamelin
AU  - Salome Hosch
AU  - Kirsten D. Mertz
AU  - Peter M. Keller
AU  - Richard Kuehl
PY  - 2026
DA  - 2026/08/18
JO  - Infection
DO  - 10.1007/s15010-026-02926-4
UR  - https://doi.org/10.1007/s15010-026-02926-4
AB  - We describe a rare case of a 35-year-old female patient suffering from polymicrobial hematogenous vertebral osteomyelitis caused by vaginal microbiota following sexual intercourse. Anaerobic blood cultures yielded Fannyhessea vaginae and Gemelliphila asaccharolytica, and intraoperative tissue cultures from decompression surgery identified Gardnerella vaginalis. Beyond Fannyhessea vaginae and Gemelliphila asaccharolytica, 16S rRNA gene Nanopore sequencing of surgical tissue also detected high amounts of Parvimonas parva, Peptostreptococcus anaerobius, Marseillibacter massiliensis, and Gemelliphila palaticanis. Antibiotic treatment with broad anaerobic coverage resulted in complete clinical resolution. Retrospective metagenomic analysis of a cervical swab obtained 9 months earlier revealed Fannyhessea vaginae and G. vaginalis to be already present in the vaginal microbiota. This case highlights the potential for hematogenous dissemination of vaginal anaerobes after sexual intercourse and underscores the diagnostic challenges posed by fastidious anaerobic bacteria. Molecular techniques are helpful tools in uncovering pathogens that may escape conventional culture methods.
SN  - 0300-8126
SN  - 1439-0973
ER  -