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脊柱广泛性多灶性气肿性骨髓炎:1例罕见病例及文献复习

Extensive Multifocal Emphysematous Osteomyelitis of Spine: A Rare Case and a Review of Literature.

作者信息

Sharma Bhawna, Lakhanpal Vikas, Goyal Abeer, Shree Ritu, Raj Shashank, Sreenivasan Priya, Biswal Manisha, Ray Pallab, Angrup Archana

机构信息

Department of Medical Microbiology, PGIMER, Chandigarh, India.

Department of Neurology, PGIMER, Chandigarh, India.

出版信息

Infect Disord Drug Targets. 2023;23(1):e140622205976. doi: 10.2174/1871526522666220614163310.

Abstract

BACKGROUND

Emphysematous osteomyelitis (EO) is an extremely rare form of osteomyelitis which is complicated mainly by infection with gas-forming organisms. The common causative agents of this disease are mainly members of Enterobacteriaceae family, the most common are Escherichia coli and Klebsiella pneumoniae along with anaerobes. A total of 48 cases of EO have been reported in the literature till now globally and none have documented the isolation of Corynebacterium amycolatum.

CASE PRESENTATION

We report a rare case of emphysematous osteomyelitis of the spine and pelvis due to Escherichia coli along with the isolation of Corynebacterium amycolatum from the same pus samples on two consecutive occasions in a 50-year-old female with uncontrolled diabetes mellitus, who was successively treated with antibiotics and drainage of pus. We also did a brief review of the literature of all cases reported till now.

CONCLUSION

The role of Corynebacterium amycolatum in the etiology of emphysematous osteomyelitis needs to be evaluated further in future studies as we cannot completely ignore its isolation in two consecutive samples as a mere contaminant.

摘要

背景

气肿性骨髓炎(EO)是一种极为罕见的骨髓炎形式,主要由产气微生物感染所致。该疾病的常见病原体主要是肠杆菌科成员,最常见的是大肠杆菌和肺炎克雷伯菌,还有厌氧菌。迄今为止,全球文献共报道了48例气肿性骨髓炎病例,尚无分离出无枝菌酸棒状杆菌的记录。

病例报告

我们报告了一例罕见的因大肠杆菌引起的脊柱和骨盆气肿性骨髓炎病例,在一名患有未控制的糖尿病的50岁女性患者中,连续两次从同一脓液样本中分离出无枝菌酸棒状杆菌,该患者先后接受了抗生素治疗和脓液引流。我们还对迄今为止报道的所有病例的文献进行了简要回顾。

结论

由于我们不能完全将连续两次样本中分离出的无枝菌酸棒状杆菌仅仅视为污染物而忽略,其在气肿性骨髓炎病因学中的作用需要在未来的研究中进一步评估。

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