Department of Surgery, Qingdao Chest Hospital, Qingdao, 266043, China.
Department of Cadre Health, Qingdao Municipal Hospital, Qingdao 266000, China.
J Infect Public Health. 2020 Oct;13(10):1586-1588. doi: 10.1016/j.jiph.2020.05.022. Epub 2020 Jun 15.
Here we describe a case of multidrug-resistant tuberculous meningitis associated with injury inflicted during spinal surgery. A 54-year-old man was diagnosed with multidrug-resistant spinal tuberculosis (TB). Anterior debridement and fusion with posterior fusion and instrumentation were conducted to remove damaged bone and TB-associated granulomatous tissue. After surgical decompression, a lancet wound (about 5mm in length) was discovered in the cerebral dura mater at the L3 position of the vertebral body. At four weeks post-surgery, the patient experienced fever, hemiparesis, and aphasia. Cerebrospinal fluid (CSF) findings were consistent with TB meningitis, while in vitro susceptibility test results confirmed that the patient had multidrug-resistant TB. Our data highlight a possible TBM infection associated with a surgical lesion in a spinal TB patient. Rapid molecular diagnostics are urgently needed to formulate efficacious regimens for treating these patients.
这里我们描述了一例与脊柱手术损伤相关的耐多药结核性脑膜炎病例。一名 54 岁男性被诊断为耐多药脊柱结核（TB）。进行了前路清创和后路融合以及内固定以去除受损的骨和与 TB 相关的肉芽肿组织。手术后 4 周，患者出现发热、偏瘫和失语。脑脊液（CSF）检查结果符合结核性脑膜炎，而体外药敏试验结果证实患者患有耐多药结核。我们的数据提示脊柱结核患者的手术损伤可能与 TBM 感染有关。迫切需要快速的分子诊断来为这些患者制定有效的治疗方案。
