因寰枢椎齿突后缘过高而导致的上颈椎硬膜外脓肿被误诊。
Delayed diagnosis of an upper cervical epidural abscess masked due to crowned dens syndrome.
机构信息
Department of Respiratory Medicine, Kobe Red Cross Hospital, Kobe, Hyogo, Japan
Department of Otolaryngology, Kobe Red Cross Hospital, Kobe, Hyogo, Japan.
出版信息
BMJ Case Rep. 2020 May 20;13(5):e235126. doi: 10.1136/bcr-2020-235126.
An 87-year-old Japanese man presented to our hospital with a 5-day history of fever and neck pain. On physical examination, his stiff neck indicated restricted movement, especially on rotation. CT of the head revealed calcification of the atlantoaxial joint consistent with crowned dens syndrome, and celecoxib was started. Four days later, he returned to our emergency department as his neck pain and fever had not improved. Pneumonia and a urinary tract infection were suspected. The day following admission, blood culture results were positive for methicillin-resistant A contrast-enhanced CT revealed an upper cervical epidural abscess at the level of C1-C2. He was discharged following 8 weeks of antibiotic treatment.
一位 87 岁的日本男性因发热和颈部疼痛 5 天到我院就诊。体格检查发现，他的颈项强直，活动受限，尤其是旋转受限。头部 CT 显示寰枢关节钙化，符合寰枢椎前脱位综合征，给予塞来昔布治疗。4 天后，他因颈部疼痛和发热未缓解再次到我院急诊科就诊。考虑肺炎和尿路感染。入院次日，血培养结果显示耐甲氧西林金黄色葡萄球菌阳性，增强 CT 显示 C1-C2 水平的上颈椎硬膜外脓肿。经过 8 周的抗生素治疗后，他出院了。
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