Physicians have difficulties interpreting the isolation of Cutibacterium acnes in the spine tissue. Here we provide the experience of our center about this topic, adding data that can help physicians in their choices. Our results show that some clinical, radiological, and microbiological features can help distinguish patients to treat or not to treat. Moreover, treatment with parenteral beta-lactams appears to be effective, but targeted oral therapy could be a valid alternative.

Non-typeable Haemophilus influenzae (NTHi) is here described for the first time as responsible for an invasive infection involving blood, vertebral and joint infection in a 79-year-old woman. It was triggered by an asymptomatic sinus condition. Surgical drainage and antibiotic therapy allowed recovery. This case shows that a full cartography of NTHi infection is unavoidable and may reveal unknown dissemination mechanisms.