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脊柱结核合并布鲁氏菌病的诊断与治疗:1例病例报告及文献复习

Diagnosis and management of spinal tuberculosis combined with brucellosis: A case report and literature review.

作者信息

Zou Dexin, Zhou Junlin, Jiang Xiaobing

机构信息

Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China.

Department of Orthopaedics, Yantai Yantaishan Hospital, Yantai, Shandong 264000, P.R. China.

出版信息

Exp Ther Med. 2018 Apr;15(4):3455-3458. doi: 10.3892/etm.2018.5812. Epub 2018 Jan 30.

Abstract

Tuberculosis combined with brucellosis is a very rare condition. Overlapping clinical presentation and laboratory parameters of tuberculosis and brucellosis may lead to misdiagnosis or delayed diagnosis of the condition. The current study presents the case of a 45-year-old male with symptoms of lower back pain, non-tender swelling in the right flank, intermittent hyperpyrexia, sweating, body aches and numbness and weakness of right lower limb. A lumbar computed tomograph (CT) scan and magnetic resonance imaging indicated vertebral destruction and the formation of sequestra and thecal sac compression. Tuberculosis was suspected, but subsequent culture of blood and pus revealed the co-infection of and . The patient was treated with antibiotics, CT-guided percutaneous drainage of the abscess and posterior approach decompression, debridement, instrumentation and fusion. Co-existence of spinal tuberculosis and brucellosis is rare and clinicians should strengthen the awareness of such conditions in similar patients. CT-guided percutaneous drainage is effective in the diagnosis and management of spinal tuberculosis with abscess.

摘要

肺结核合并布鲁氏菌病是一种非常罕见的病症。肺结核和布鲁氏菌病重叠的临床表现及实验室参数可能导致该病的误诊或诊断延误。本研究报告了一例45岁男性病例,该患者有下背部疼痛、右侧胁腹无痛性肿胀、间歇性高热、出汗、全身疼痛以及右下肢麻木和无力等症状。腰椎计算机断层扫描(CT)和磁共振成像显示椎体破坏、死骨形成以及硬脊膜囊受压。怀疑为肺结核,但随后的血液和脓液培养显示 和 合并感染。该患者接受了抗生素治疗、CT引导下经皮脓肿引流以及后路减压、清创、器械植入和融合手术。脊柱结核和布鲁氏菌病并存的情况罕见,临床医生应加强对类似患者此类病症的认识。CT引导下经皮引流对伴有脓肿的脊柱结核的诊断和治疗有效。

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