Anderson Brenna L, Nau Gerard J, Simhan Hyagriv N
Department of Obstetrics and Gynecology, Brown Medical School/Women & Infants' Hospital of Rhode Island, Providence, Rhode Island, USA.
Am J Perinatol. 2007 Jun;24(6):377-9. doi: 10.1055/s-2007-981850. Epub 2007 Jun 13.
Pregnant women are prone to complications from many infections. However, overwhelming soft tissue infections are rarely reported in pregnant women without predisposing factors. A 40-year-old multipara presented with complaints of progressively worsening spinal muscle spasm pain. Because her medical history consisted of preterm deliveries, she was receiving injections of 17-alpha-hydroxyprogesterone caproate (17P). An imaging study revealed replacement of the vertebral marrow with a homogeneous substance. A biopsy stained for gram-positive cocci. Blood culture bottles grew STAPHYLOCOCCUS AUREUS. The lesion was re-aspirated, and grew the same isolate. The patient was treated with antibiotics and had resolution of her pain. Mother and infant did well, and she completed a prolonged course of antibiotics. This study presents an unusual case of idiopathic vertebral osteomyelitis and epidural abscess during pregnancy. Potential reasons for failure to display a systemic response to this infection with associated bacteremia include an innate variation in the patient's immune system and modification in immunity from progesterone therapy. The role that 17P played in this case, if any, is unknown.
孕妇容易因多种感染而出现并发症。然而，在没有易感因素的孕妇中，严重的软组织感染很少见报道。一名40岁经产妇因脊柱肌肉痉挛性疼痛逐渐加重前来就诊。由于她有早产病史，一直在接受己酸17-α-羟孕酮（17P）注射。影像学检查显示椎骨髓被一种均匀物质替代。活检染色显示革兰氏阳性球菌。血培养瓶中培养出金黄色葡萄球菌。对病变部位再次进行穿刺抽吸，培养出相同的分离菌。患者接受了抗生素治疗，疼痛得以缓解。母婴情况良好，她完成了一个较长疗程的抗生素治疗。本研究报告了一例孕期特发性椎体骨髓炎和硬膜外脓肿的罕见病例。未能对这种伴有菌血症的感染表现出全身反应的潜在原因包括患者免疫系统的先天性变异以及孕激素治疗对免疫的改变。17P在该病例中所起的作用（如果有）尚不清楚。
