Chek Siang Kelvin Cheng, Ahmad Fauzi Aishah, Hasnan Nazirah
a Department of Rehabilitation , Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia.
J Spinal Cord Med. 2017 Jan;40(1):113-117. doi: 10.1080/10790268.2015.1133016. Epub 2016 Feb 25.
Infection and septicaemia may clinically presented with seizure and altered conscious level. In spinal cord injury (SCI) population, they are at risk of having pressure ulcer which can be complicated further with infection and septicaemia.
A 40-year-old man with complete T4 SCI and multiple clean and non-healing pressure ulcers at sacral and bilateral ischial tuberosity regions was initially admitted for negative pressure wound therapy (NPWT) dressing. He had an episode of seizure and subsequently had fluctuating altered conscious level before the diagnosis of deep-seated sacral abscess was made and managed. Prior investigations to rule out common possible sources of infections and management did not resolve the fluctuating event of altered consciousness.
We presented an unusual case presentation of septicemia in a patient with SCI with underlying chronic non-healing pressure ulcer. He presented with seizure and fluctuating altered conscious level. Even though a chronic non-healing ulcer appeared clinically clean, a high index of suspicion for deep seated abscess is warranted as one of the possible sources of infection, especially when treatment for other common sources of infections fails to result in clinical improvement.
感染和败血症在临床上可能表现为癫痫发作和意识水平改变。在脊髓损伤（SCI）人群中，他们有发生压疮的风险，而压疮可能会进一步并发感染和败血症。
一名40岁的男性，T4完全性脊髓损伤，骶部和双侧坐骨结节区域有多处清洁但不愈合的压疮，最初因负压伤口治疗（NPWT）敷料入院。在诊断出深部骶部脓肿并进行处理之前，他曾有一次癫痫发作，随后意识水平波动。之前为排除常见感染源而进行的检查和处理并未解决意识水平波动的问题。
我们报告了一例脊髓损伤患者合并潜在慢性不愈合压疮并发败血症的不寻常病例。他表现为癫痫发作和意识水平波动。尽管慢性不愈合溃疡在临床上看起来清洁，但仍需高度怀疑深部脓肿是可能的感染源之一，尤其是当针对其他常见感染源的治疗未能带来临床改善时。
