Department of Internal Medicine, Wayne State University, Detroit, Michigan, USA
Department of Internal Medicine, Sinai Grace Hospital, Detroit, Michigan, USA.
BMJ Case Rep. 2021 Nov 1;14(11):e245675. doi: 10.1136/bcr-2021-245675.
We report a case of a 54-year-old immunocompetent male who had lung abscess secondary to that led to discitis by contiguous spread of infection. He initially presented with constant chest pain for 6 weeks that radiated to lower back, with no fever, chills or weight loss. He denied smoking cigarettes, alcohol use or any illicit drug. On investigation, a mass was identified on the posterior medial aspect of the right lower lobe with direct infiltration into right side of the T5-T6 vertebral bodies. Histopathology identified organising pneumonia with abscess. Tissue cultures showed , and were negative for other microorganisms. This case highlights a rare presentation of discitis by contiguous spread of infection from posterior right lower lobe lung abscess. usually occurs in older patients with pulmonary infections complicated with pleural effusion or lung abscess, but can present in young patients with no clear symptoms of lung infection, like our patient.
我们报告了一例 54 岁免疫功能正常的男性患者,他因肺部脓肿继发感染,导致椎间盘炎。他最初表现为持续 6 周的胸痛,放射至下背部,无发热、寒战或体重减轻。他否认吸烟、饮酒或任何非法药物。经调查,在右下叶后内侧发现一个肿块,直接浸润到 T5-T6 椎体的右侧。组织病理学显示机化性肺炎伴脓肿。组织培养显示为 ,其他微生物均为阴性。本例提示了一种罕见的肺部脓肿通过连续感染导致椎间盘炎的表现。通常发生在有肺部感染合并胸腔积液或肺脓肿的老年患者中,但也可发生在无明显肺部感染症状的年轻患者中,就像我们的患者一样。