Russell Wendy, Taylor William, Ray Gautamanada, Gravil Jane, Davidson S
MBChB(Ed), MRCP. StR4 in General Internal Medicine (Acute). Monklands Hospital. Monkscourt Avenue, Airdrie, ML6 0JS.
Acute Med. 2011;10(1):35-7.
A 51-year-old man presenting with left arm weakness and slurred speech was referred to the acute medical team. Admission chest X-ray showed a cavitating lesion, which had not been present 2 weeks earlier. Systemic enquiry elicited a 2 month prodromal illness and back pain. Urgent CT of his head and chest revealed evidence of thoracic discitis spreading anteriorly into a pleural-based lung abscess and an intracerebral abscess causing his neurological deficit. He was transferred for urgent craniotomy and evacuation of a Streptococcus milleri abscess. Following several weeks of neurosurgical care and antibiotics he made a near full recovery.
一名51岁男性因左臂无力和言语不清被转诊至急性医疗队。入院时胸部X光显示有一个空洞性病变，而两周前还不存在。系统询问发现有2个月的前驱疾病和背痛。他的头部和胸部紧急CT显示有胸椎椎间盘炎向前蔓延至胸膜下肺脓肿及脑脓肿，导致其神经功能缺损。他被转至急症室进行紧急开颅手术，以清除米勒链球菌脓肿。经过数周的神经外科护理和抗生素治疗，他几乎完全康复。
