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沙门氏菌性脊椎炎:胸椎脊柱炎 1 例报告并文献复习。

Salmonella enteritis spondylitis of thoracic spine: a case report and review of the literature.

机构信息

Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong An Road, XiCheng District, Beijing, 100050, China.

出版信息

BMC Surg. 2020 Aug 7;20(1):180. doi: 10.1186/s12893-020-00841-5.

Abstract

BACKGROUND

Spondylitis is a very common back problem in orthopedics, but is rarely caused by Salmonella enteritidis. We herein reported an uncommon case of thoracic spondylitis caused by Salmonella enteritidis.

CASE PRESENTATION

A 68-year-old man with high fever was diagnosed as salmonella septicemia initially. His condition was improved after antibacterial treatment. But the symptom of pyrexia was recurred after some days. He was then diagnosed with thoracic spondylitis caused by salmonella enteritidis. After that, he was put on strict antibiotic treatment, and underwent intervertebral lesion debridement, partial rib resection, intervertebral bone fusion and pedicle screw internal fixation. Subsequently, the patient had a significant relief in pain, temperature remained normal, and had no severe complications.

CONCLUSIONS

Special attention should be paid to systemic pain and remain cautious to the occurrence of osteomyelitis in patients with Salmonella septicemia. Moreover, the treatment time for using sensitive antibiotics should be sufficient. Surgical treatment should be considered if strict conservative treatment is failed.

摘要

背景

脊柱关节炎是骨科中一种非常常见的背部问题,但很少由肠炎沙门氏菌引起。我们在此报告一例由肠炎沙门氏菌引起的不常见的胸椎脊柱关节炎。

病例介绍

一名 68 岁男性,因高热最初被诊断为沙门氏菌败血症。经过抗菌治疗后,他的病情有所改善。但几天后,发热症状再次出现。然后,他被诊断为肠炎沙门氏菌引起的胸椎脊柱关节炎。之后,他接受了严格的抗生素治疗,并进行了椎间隙病变清创术、部分肋骨切除术、椎间骨融合和椎弓根螺钉内固定术。随后,患者疼痛明显缓解,体温恢复正常,无严重并发症。

结论

对于沙门氏菌败血症患者,应特别注意全身疼痛,并警惕骨髓炎的发生。此外,使用敏感抗生素的治疗时间应充足。如果严格保守治疗失败,应考虑手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f30/7430869/050bcc38dcb8/12893_2020_841_Fig1_HTML.jpg

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