Is Shigella an under-recognized pathogen? A case of pyogenic cervical spondylitis caused by and infection.

typically causes gastrointestinal infections, and extra-intestinal manifestations are rare. We report the first known case of pyogenic cervical spondylitis co-infected with and , highlighting the diagnostic challenges and clinical implications. A 53-year-old woman presented with neck pain for one month. MRI revealed C6 and C7 vertebrae abscesses. The patient underwent anterior cervical debridement and bone-graft fusion. Intraoperative pus culture grew , while metagenomic next-generation sequencing detected both and species. Intravenous imipenem 500 mg every 6 h was administered, leading to full wound healing at a 6-month follow-up. This case emphasizes the importance of considering infection in the differential diagnosis of pyogenic spondylitis and demonstrates the utility of a multi-pronged diagnostic approach.