Hatter Matthew J, Beyer Ryan S, Camino-Willhuber Gaston, Franklin Austin, Brown Nolan J, Hashmi Sohaib, Oh Michael, Bhatia Nitin, Lee Yu-Po
School of Medicine, and.
Departments of Orthopaedics and.
J Neurosurg Case Lessons. 2022 Jun 27;3(26):CASE22157. doi: 10.3171/CASE22157.
Primary spinal infections (PSIs) are a group of uncommon but serious infectious diseases considered more prevalent and aggressive among patients with chronic immunocompromised states. Association of PSI and solid organ transplant has not been systematically analyzed. The authors performed a systematic review analyzing clinical presentation and mortality of patients with PSI in the setting of solid organ transplant.
PSIs in patients with immunosuppressive therapy, such as those with solid organ transplant, may behave differently in terms of epidemiology, clinical presentation, and outcomes compared with nonimmunosuppressed patients. Overall PSI in solid organ transplant patients is associated with a high rate of neurological compromise, postoperative complications, and mortality.
Accurate diagnosis and appropriate treatment of PSI require a multidisciplinary effort. Localized pain is the most frequently reported symptom associated with PSI. As opposed to PSI in patients without transplant, inflammatory and infectious markers such as white blood cells and C-reactive protein are often not elevated. Furthermore, the causative microorganism profile varies significantly when compared to pyogenic spinal infection in patients without transplant. species was responsible for spondylodiscitis in transplant patients in more than 50% of cases, and the incidence of infection is projected to rise in the coming years.
原发性脊柱感染（PSIs）是一组罕见但严重的感染性疾病，在慢性免疫功能低下患者中被认为更为常见且具有侵袭性。PSIs与实体器官移植之间的关联尚未得到系统分析。作者进行了一项系统综述，分析实体器官移植背景下PSIs患者的临床表现和死亡率。
接受免疫抑制治疗的患者，如实体器官移植患者，其PSIs在流行病学、临床表现和预后方面可能与非免疫抑制患者有所不同。实体器官移植患者的总体PSIs与神经功能损害、术后并发症和死亡率的高发生率相关。
准确诊断和适当治疗PSIs需要多学科的努力。局部疼痛是与PSIs相关的最常报告症状。与未接受移植的患者的PSIs不同，白细胞和C反应蛋白等炎症和感染标志物通常不会升高。此外，与未接受移植的患者的化脓性脊柱感染相比，致病微生物谱有显著差异。超过50%的病例中， 菌种是移植患者椎间盘炎的病因，预计未来几年 感染的发生率会上升。
