Background: Vertebral osteomyelitis most often presents with back pain and is usually a secondary complication of a distant infection with hematogenous seeding. A source of infection is detected in about half of the cases. Burkholderia cepacia has rarely been implicated as an etiology. Case Presentation: We present a 50 year old Caucasian male with low back pain for 10 days associated with urinary incontinence without any fever or chills. He had laboratory and imaging evidence of vertebral osteomyelitis. Patient underwent bone biopsy and was diagnosed with vertebral osteomyelitis and discitis caused by Burkholderia cepacia. The patient was treated with intravenous meropenem for initial two weeks and thereafter oral ciprofloxacin and continues to do well several weeks later. Conclusion: Vertebral osteomyelitis due to B. cepacia has rarely been reported as a cause and though rare this organism should be considered in the differential diagnosis of vertebral osteomyelitis in the appropriate clinical setting.

Keywords: Vertebral osteomyelitis, Burkholderia cepacia, bone biopsy, mechanism of resistance.