School for Doctoral Studies in Biomedical Sciences "Dunarea de Jos" University from Galati, 800008 Galati, Romania.
Pneumophtiziology Hospital Galati, 800189 Galati, Romania.
Medicina (Kaunas). 2023 Mar 20;59(3):616. doi: 10.3390/medicina59030616.
COVID-19 is currently a major health problem, leading to respiratory, cardiovascular and neurological complications, with additional morbidity and mortality. Spinal infections are rare, representing around 1% of all bone infections and comprising less than 2 per 10,000 of all hospitalizations in tertiary care centers. Spondylodiscitis is a complex disease, with challenging diagnosis and management. We report the case of a 45-year-old man, non-smoker hospitalized for severe COVID-19 disease with respiratory failure. Post-COVID-19, in the 8th week after discharge, he was diagnosed by magnetic resonance imaging with spondylodiscitis, but etiology was not confirmed by microbiological investigations. Antibiotics were used, considering the identification of MRSA from cultures of pleural fluid and nasal swab, but surgical intervention was not provided. Clinic, biologic and imagistic were improved, but rehabilitation and long term follow up are necessary. We concluded that spondylodiscitis with spinal abscess is a rare but severe complication post-COVID-19 disease, due to dysbalanced immune response related to the respiratory viral infection, endothelial lesions, hypercoagulation and bacterial superinfection.
COVID-19 目前是一个主要的健康问题，导致呼吸系统、心血管系统和神经系统并发症，并有额外的发病率和死亡率。脊柱感染很少见，占所有骨感染的 1%左右，在三级保健中心的所有住院病例中不到 2/10000。脊椎炎是一种复杂的疾病，诊断和治疗具有挑战性。我们报告了一例 45 岁男性的病例，不吸烟，因严重 COVID-19 疾病伴呼吸衰竭住院。COVID-19 后，在出院后第 8 周，他被磁共振成像诊断为脊椎炎，但微生物学检查未确定病因。考虑到从胸腔液和鼻拭子培养中鉴定出了 MRSA，使用了抗生素，但未进行手术干预。临床、生物学和影像学均有所改善，但需要康复和长期随访。我们的结论是，COVID-19 后脊椎炎伴脊椎脓肿是一种罕见但严重的并发症，是由于与呼吸道病毒感染相关的免疫反应失衡、内皮损伤、高凝和细菌继发感染引起的。
