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真菌性脊椎椎间盘炎:影像学表现及文献复习。

Fungal spondylodiscitis: imaging findings and brief review of the literature.

机构信息

Clinica III, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

Department of Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

出版信息

BMJ Case Rep. 2021 Sep 3;14(9):e242515. doi: 10.1136/bcr-2021-242515.

Abstract

A 57-year-old man was admitted to our department reporting persistent low back and leg pain; this patient had undergone chemotherapy 1 year earlier for acute myeloid leukaemia (AML). During chemotherapy, he exhibited bilateral pneumonia due to , which was treated by specific antibiotic therapy, and septicaemia by MRI showed the presence of spondylodiscitis. A CT-guided needle biopsy was performed and the culture from the excised material tested positive for We report a rare case of spondylodiscitis by in a patient treated for AML, which, in turn, was followed by sepsis from and Without adequate treatment, the disease is progressive, and leads to vertebral destruction with secondary kyphosis and neural or spinal cord compression. Although MRI has high sensitivity in the diagnosis of spondylodiscitis, open or needle biopsy allows to identify the aetiology.

摘要

一位 57 岁男性因持续性腰背和下肢疼痛就诊于我科,该患者 1 年前因急性髓系白血病(AML)接受化疗。化疗期间,患者因感染发生双侧肺炎,经特定抗生素治疗后痊愈,又因感染出现菌血症。磁共振成像(MRI)显示存在脊椎炎。进行 CT 引导下的针吸活检,切除物的培养结果为阳性。我们报告一例 AML 治疗后发生的罕见由感染引起的脊椎炎病例,继而由感染引起败血症和感染性心内膜炎。如果不进行充分治疗,疾病会进展,导致椎体破坏,继发后凸畸形和神经或脊髓压迫。尽管 MRI 对脊椎炎的诊断具有高灵敏度,但开放性或针吸活检有助于确定病因。

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