Enterococcus faecalis is distributed in the intestines and rarely becomes a pathogen of spinal infection. This article reports a case of delayed spinal enterococcus faecalis infection caused by transperineal prostate biopsy. The patient was found to have a serum tPSA level of 33.418 ng/ml during prostate cancer screening. A prostate biopsy was performed，and the pathological result was benign prostatic hyperplasia. One month after the operation，the patient presented with recurrent low back pain. Contrast-enhanced MRI of the lumbar spine showed infectious lesions of the T12 and L1 vertebrae with pathological compression fractures. A puncture biopsy of the diseased vertebra was performed，and the metagenomic test showed enterococcus faecalis infection. Anti-infection and bed rest conservative treatment were given. Follow-up for 1 year showed fracture healing and infection control.

Enterococcus faecalis is distributed in the intestines and rarely becomes a pathogen of spinal infection. This article reports a case of delayed spinal enterococcus faecalis infection caused by transperineal prostate biopsy. The patient was found to have a serum tPSA level of 33.418 ng/ml during prostate cancer screening. A prostate biopsy was performed，and the pathological result was benign prostatic hyperplasia. One month after the operation，the patient presented with recurrent low back pain. Contrast-enhanced MRI of the lumbar spine showed infectious lesions of the T12 and L1 vertebrae with pathological compression fractures. A puncture biopsy of the diseased vertebra was performed，and the metagenomic test showed enterococcus faecalis infection. Anti-infection and bed rest conservative treatment were given. Follow-up for 1 year showed fracture healing and infection control.