Abstract
Introduction: Spinal implant infections (SIIs) are a rare but well-known complication of spinal surgery. Early SIIs are usually caused by Staphylococcus aureus, beta-haemolytic streptococci, or Gram-negative bacilli. On the other hand, late-onset SIIs are usually caused by coagulase-negative staphylococci or Cutibacterium acnes. Case description: Here, we present a rare case of a late-onset SII in a 24-year-old dentist, caused by oral streptococcal flora (Streptococcus salivarius) that was probably inoculated into his conjunctival mucous membrane by a blood splash during a dental procedure, seven years after spinal fusion. He was initially treated broadly with empiric antibiotics as the organism was not identified, until it was later isolated from an intraoperative tissue culture. After that, he was given targeted antimicrobial therapy along with implant removal. Discussion: The conjunctival mucosa is a well-established route of entry for blood-borne pathogens, particularly viral organisms, in health-care settings. Conclusion: This treatment strategy resulted in significant improvement of his symptoms and general condition.