McHenry M C, Duchesneau P M, Keys T F, Rehm S J, Boumphrey F R
Department of Infectious Diseases, Cleveland Clinic Foundation, OH 44106.
Arch Intern Med. 1988 Feb;148(2):417-23.
Six patients with osteoporosis had vertebral osteomyelitis (VO) with infection of a single vertebra that presented with a collapsed vertebral body, thought to be a simple compression fracture. The resulting delay in correctly diagnosing VO was associated with disabling sequelae in a high proportion of cases. This distinctive presentation accounted for 13% of all hospitalized patients with VO and 2.4% of inpatients with osteoporotic compression fractures during the last five years; it may be more common than suggested by the paucity of published cases. In patients with osteoporosis and vertebral compression fractures, osteomyelitis should be considered when there is severe back pain, persistent unexplained fever, unexplained elevation of the erythrocyte sedimentation rate, or bacteremia without an obvious extravertebral focus of infection, particularly if the patient is immunocompromised. Early biopsy and culture of the collapsed vertebral body will facilitate diagnosis and therapy.
六名骨质疏松症患者发生了椎体骨髓炎（VO），单个椎体感染，表现为椎体塌陷，最初被认为是单纯性压缩骨折。由此导致的VO正确诊断延迟在很大比例的病例中与致残后遗症相关。这种独特的表现占过去五年中所有住院VO患者的13%，以及骨质疏松性压缩骨折住院患者的2.4%；它可能比已发表病例的稀少情况所显示的更为常见。在患有骨质疏松症和椎体压缩骨折的患者中，当出现严重背痛、持续不明原因发热、不明原因的红细胞沉降率升高或无明显椎体外感染灶的菌血症时，应考虑骨髓炎，特别是如果患者免疫功能低下。对塌陷椎体进行早期活检和培养将有助于诊断和治疗。
