Barton Edward, Flanagan Paul, Hill Simon
Department of Microbiology, North Bristol NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK.
J Infect. 2008 Oct;57(4):347-9. doi: 10.1016/j.jinf.2008.08.001. Epub 2008 Sep 19.
A case of cervical epidural abscess in a 63-year-old woman with a complex gastrointestinal surgical history is reported. The presenting symptom was neck pain, and blood analysis demonstrated raised erythrocyte sedimentation rate and C-reactive protein. MR imaging of the cervical spine revealed cervical discitis, osteomyelitis, and epidural collection. An ESBL-producing strain of Klebsiella pneumoniae, isolated from a previous episode of bacteraemia, was the causative organism. Surgical treatment was not possible and initial carbapenem therapy was aborted due to development of neutropaenia, and treatment continued with an extended course of temocillin. After 12 weeks of antibiotics the patient was pain-free with radiological improvement and resolution of blood markers of infection.
报告了一例63岁女性颈椎硬膜外脓肿病例，该患者有复杂的胃肠手术史。主要症状为颈部疼痛，血液分析显示红细胞沉降率和C反应蛋白升高。颈椎磁共振成像显示颈椎间盘炎、骨髓炎和硬膜外积液。从先前一次菌血症中分离出的产超广谱β-内酰胺酶的肺炎克雷伯菌是病原体。由于出现中性粒细胞减少症，无法进行手术治疗，最初的碳青霉烯类治疗也中止，改用替莫西林延长疗程继续治疗。使用抗生素12周后，患者疼痛消失，影像学检查有改善，感染的血液指标也恢复正常。
