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感染性脊柱骨髓炎-病例系列分析。

Infectious spondylodiscitis - a case series analysis.

机构信息

Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland.

Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland.

出版信息

Adv Med Sci. 2014 Mar;59(1):57-60. doi: 10.1016/j.advms.2014.02.001. Epub 2014 Mar 19.

Abstract

PURPOSE

We aimed to describe the clinical and laboratory features as well as diagnostic difficulties in the case series of spondylodiscitis.

MATERIALS/METHODS: We retrospectively reviewed 11 cases of spondylodiscitis. The diagnosis of spondylodiscitis was based on clinical, radiological and microbiological evidence and by the response to antimicrobial therapy.

RESULTS

There were 7 men and 4 women, and the age ranged from 21 to 74 years. Risk factors of spondylodiscitis were observed in 7 patients. The approximate time from onset of symptoms to diagnosis was from 2 to 7 months (median 45 days). Back pain was the most common symptom. The most frequent location of spondylodiscitis was lumbar spine. Pathogens were isolated in 6 cases and were as follows: Staphylococcus aureus (4 cases), Staphylococcus warneri (1 case) and Escherichia coli (1 case). After therapy, all patients had rapid regression of symptoms and no permanent neurological impairments and recurrence of infection were observed.

CONCLUSIONS

Diagnosis of spondylodiscitis is frequently delayed. This disease should be taken into consideration in differential diagnosis in patients with root syndromes accompanied by back pain and usually fever as well as increased values of CRP and ESR.

摘要

目的

我们旨在描述脊柱骨髓炎的病例系列中的临床和实验室特征以及诊断难点。

材料/方法:我们回顾性分析了 11 例脊柱骨髓炎患者。脊柱骨髓炎的诊断基于临床、影像学和微生物学证据,并通过对抗菌治疗的反应来确定。

结果

7 例为男性,4 例为女性,年龄从 21 岁至 74 岁不等。7 例患者存在脊柱骨髓炎的危险因素。从症状发作到诊断的时间约为 2 至 7 个月(中位数为 45 天)。背痛是最常见的症状。脊柱骨髓炎最常见的部位是腰椎。6 例患者分离出病原体,分别为:金黄色葡萄球菌(4 例)、华纳葡萄球菌(1 例)和大肠杆菌(1 例)。经治疗后,所有患者的症状迅速缓解,无永久性神经损伤,也未观察到感染复发。

结论

脊柱骨髓炎的诊断常常被延误。对于伴有背痛、通常发热以及 CRP 和 ESR 升高的根综合征患者,应考虑将其作为鉴别诊断的一种疾病。

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