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Background Esophageal injury is a common complication of foreign bodies in the upper gastrointestinal tract, but bilateral pleural effusion or vertebral infection is a rare condition due to a swallowed fishbone. It is considerably difficult for a physician to diagnose quickly because of incomplete patient history of foreign bodies ingestion and/or insufficient experiences. Patient concerns We describe the case of a 56-year-old man who was admitted to an emergency medical department owing to a low to moderate fever for 7 days. After a series of examinations, the patient was diagnosed with esophageal perforation (EP) caused by a fishbone that was swallowed half a month ago. Diagnoses About 12 days after the onset of fever, he was diagnosed with EP based on the gastric endoscopic images combined with histological section and sufficient history of the disease. About 2 months later, the patient has obvious back pain and lack of strength in two legs and was diagnosed with vertebral body infection. Interventions Antibiotic therapy, multi-disciplinary team (MDT), and surgical intervention had been exerted. Outcomes It is very fortunate for this patient to have a good prognosis due to a timely diagnosis and proper management. Muscle power has attained level 5. Lessons Several lessons can be learned from this case; for example, physicians should be alerted to the EP, endoscopic intervention should be prompt, antibiotics should be used regularly, and so on.

Vertebral body infection due to esophageal perforation caused by ingestion of fishbone: a case report