A 68-year-old woman was hospitalized for disabling back pain refractory to analgesic therapy. The pain started two weeks earlier when she sustained an osteoporotic compression fracture of the L5 vertebral body with 35% loss of its anterior height. She had no significant medical or family history. There was no known allergy. Percutaneous vertebroplasty was performed under local anaesthesia and conscious sedation using intravenous meperidine (50 mg) and midazolam. She remained hemodynamically stable throughout the procedure. The procedure slightly improved her back pain.
On the next morning, 24 hours after the surgery, she developed a mild fever, chest discomfort, and productive cough of yellowish sputum, with flu-like symptoms. On the third postoperative day, she developed arthralgia, myalgia, fever (38.3 C), and frequent coughing. Over the next few hours, her symptoms were rapidly aggravated, becoming clammy, cyanosed, and confused while complaining of shortness of breath.
Chest radiography revealed bilateral, multifocal, patchy consolidations and a 5-cm-long tubular radio-opacity in the right pulmonary. CT scan was performed. She died 20 days after the vertebroplasty.
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