Khoo Hau Wei, Chua Ying Ying, Chen John L T
Department of Orthopaedics Surgery, Singapore General Hospital, Outram Road, Singapore 169608.
Department of Infectious Diseases, Singapore General Hospital, Outram Road, Singapore 169608.
Case Rep Orthop. 2016;2016:6798157. doi: 10.1155/2016/6798157. Epub 2016 Mar 10.
Salmonella vertebral osteomyelitis is an uncommon complication of Salmonella infection. We report a case of a 57-year-old transgender male who presented with lower back pain for a period of one month following a fall. Physical examination only revealed tenderness over the lower back with no neurological deficits. MRI of the thoracic and lumbar spine revealed a spondylodiscitis at T10-T11 and T12-L1 and right posterior epidural collection at the T9-T10 level. He underwent decompression laminectomy with segmental instrumentation and fusion of T8 to L3 vertebrae. Intraoperatively, he was found to have acute-on-chronic osteomyelitis in T10 and T11, epidural abscess, and discitis in T12-L1. Tissue and wound culture grew Salmonella Typhi and with antibiotics susceptibility guidance he was treated with intravenous ceftriaxone for a period of six weeks. He recovered well with no neurological deficits.
沙门氏菌性脊椎骨髓炎是沙门氏菌感染的一种罕见并发症。我们报告一例57岁的变性男性病例,该患者在跌倒后出现下背部疼痛达一个月。体格检查仅发现下背部压痛,无神经功能缺损。胸腰椎MRI显示T10 - T11和T12 - L1椎体间盘炎,以及T9 - T10水平右侧硬膜外积液。他接受了减压椎板切除术,并行T8至L3椎体节段性内固定和融合术。术中发现他T10和T11有急性加重的慢性骨髓炎、硬膜外脓肿以及T12 - L1椎间盘炎。组织和伤口培养出伤寒沙门氏菌,在抗生素敏感性指导下,他接受了为期六周的静脉注射头孢曲松治疗。他恢复良好,无神经功能缺损。