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一名年轻男性发生的脊椎椎间盘炎——诊断和治疗难题

Spondylodiscitis developing in a young man - diagnostic and therapeutic difficulties.

作者信息

Kalinova Desislava, Rashkov Rasho

机构信息

Clinic of Rheumatology, UMHAT St. Ivan Rilski University Hospital, Sofia, Bulgaria.

出版信息

Reumatologia. 2018;56(5):328-332. doi: 10.5114/reum.2018.79505. Epub 2018 Oct 31.

Abstract

Infectious spondylodiscitis is characterized by vertebral osteomyelitis, spondylitis, and discitis. Patients present with persistent low back pain, fever, or neurological findings. Diagnosis is made with a combination of clinical, radiological, and laboratory findings. Magnetic resonance tomography (MRI) has high sensitivity and specificity in diagnosis and differentiation of the type of spondylodiscitis and may reveal signs of spondylodiscitis even in very early stages. Infectious spondylodiscitis responds to antimicrobial therapy well if diagnosed early before development of neurological deficit and requirement of surgical intervention. We present a clinical case of spondylodiscitis developing in a young immunocompetent man without any predisposing factors.

摘要

感染性脊椎间盘炎的特征是椎体骨髓炎、脊柱炎和椎间盘炎。患者表现为持续性腰痛、发热或神经学症状。诊断需结合临床、影像学和实验室检查结果。磁共振断层扫描(MRI)在感染性脊椎间盘炎的诊断及类型鉴别中具有高敏感性和特异性,甚至在疾病极早期即可发现脊椎间盘炎的征象。如果在出现神经功能缺损及需要手术干预之前早期诊断,感染性脊椎间盘炎对抗菌治疗反应良好。我们报告一例在无任何易感因素的年轻免疫功能正常男性中发生的脊椎间盘炎临床病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b2/6263306/5d470dd5baf3/RU-56-79505-g001.jpg

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