Ishihara Toshinobu, Miyazaki Masashi, Yoshiiwa Toyomi, Notani Naoki, Tsumura Hiroshi
Department of orthopaedic surgery, faculty of medicine, Oita university, 1-1, Idaigaoka, Hasama-machi, Yufu-shi, 879-5593 Oita, Japan.
Department of orthopaedic surgery, faculty of medicine, Oita university, 1-1, Idaigaoka, Hasama-machi, Yufu-shi, 879-5593 Oita, Japan.
Joint Bone Spine. 2016 Dec;83(6):727-729. doi: 10.1016/j.jbspin.2016.01.009. Epub 2016 May 25.
Septic vertebral osteomyelitis caused by Yersinia pseudotuberculosis is extremely rare. We report the first case of pyogenic vertebral osteomyelitis due to Y. pseudotuberculosis. A 65-year-old man presented with low back pain and fever. He had a history of psoriasis vulgaris treated with adalimumab. The patient reported drinking adequate amounts of well water daily. Clinical examination revealed no neurological deficit of the lower limbs. Laboratory findings included increased inflammatory reactions. Magnetic resonance imaging showed diffuse changes in intensity at the T10 and L3 vertebrae, and multiple nodular lesions in the thoracic, lumbar, sacral, and iliac regions. We performed an open biopsy. Y. pseudotuberculosis was cultured from both the T10 and L3 vertebrae lesions. Y. pseudotuberculosis is sensitive to almost all antibiotics. After initiating antibiotic treatment, the laboratory parameters normalized and the patient recovered completely, without any neurological deficits. To our knowledge, our report represents the first case of pyogenic vertebral osteomyelitis due to Y. pseudotuberculosis.
由假结核耶尔森菌引起的化脓性脊椎骨髓炎极为罕见。我们报告了首例由假结核耶尔森菌引起的化脓性脊椎骨髓炎病例。一名65岁男性出现腰痛和发热症状。他有寻常型银屑病病史,曾接受阿达木单抗治疗。患者自述每天饮用足量的井水。临床检查未发现下肢神经功能缺损。实验室检查结果显示炎症反应增强。磁共振成像显示T10和L3椎体信号弥漫性改变,胸、腰、骶及髂骨区域有多个结节性病变。我们进行了开放性活检。从T10和L3椎体病变处均培养出假结核耶尔森菌。假结核耶尔森菌对几乎所有抗生素敏感。开始抗生素治疗后,实验室指标恢复正常,患者完全康复,未遗留任何神经功能缺损。据我们所知,我们的报告是首例由假结核耶尔森菌引起的化脓性脊椎骨髓炎病例。