To investigate the clinical characteristics, diagnostic challenges and antimicrobial therapeutic strategies of vertebral infection caused by Janibacter terrae, so as to provide evidence for the diagnosis and management of rare bacterial vertebral infections.

The clinical data of one adolescent patient with Janibacter-induced vertebral infection who was admitted to Shandong Provincial Hospital Affiliated to Shandong First Medical University on December 11st, 2024 were analyzed, retrospectively. Relevant literature on Janibacter terrae infections published from database establishment to April 29th, 2025 was retrieved from CNKI, Wanfang and PubMed databases to summarize the clinical manifestations and anti-infection regimens of Janibacter terrae infection.

The 15-year-old male patient had no underlying diseases, and the chief complaint was chest and waist pain. Laboratory tests revealed elevated inflammatory biomarkers, C-reactive protein: 83.32 mg/L, serum amyloid A: 348.26 mg/L, procalcitonin: 0.31 ng/ml, interleukin-6: 99.96 pg/ml and erythrocyte sedimentation rate: 48.00 mm/h. Computed tomography (CT) and magnetic resonance imaging (MRI) showed abnormal lesions at the T5 vertebral body. Pathogen identification of Janibacter terrae was confirmed via metagenomic next-generation sequencing (mNGS) of bone tissue. Combined antimicrobial therapy with linezolid (600 mg every 12 hours) plus amikacin (400 mg once daily) achieved favorable therapeutic efficacy. The patient recovered well during the half-year follow-up.

Vertebral infection induced by Janibacter terrae is rare. mNGS facilitates rapid etiological confirmation. Timely administration of susceptible antibiotics with excellent bone tissue penetration is recommended once definite diagnosis is confirmed.