A case of surgical site infection with severe spondylitis caused by Streptococcus gordonii in an adult healthy woman. How to apply medico-legal method to deny malpractice hypothesis in suspected healthcare-associated infection

We describe a rare case of severe primary spondylitis caused by Streptococcus gordonii in a 45-year-old immunocompetent woman with no relevant comorbidities. The surgical site infection arose after a L4–L5 microdiscectomy and resulted in severe clinical disability. Allegations of possible negligence as the cause prompted a forensic review to clarify the original source and transmission of this uncommon pathogen, which dismissed its cause as due to malpractice during treatment.