Frimley Park Hospital NHS Foundation Trust, Frimley, UK
Frimley Park Hospital NHS Foundation Trust, Frimley, UK.
BMJ Case Rep. 2023 May 2;16(5):e252457. doi: 10.1136/bcr-2022-252457.
This case report describes a clinical presentation of spondylodiscitis, following an emergency ureteric stent placement for an infected and obstructed kidney in a woman in her late 70s who presented with right flank pain, raised inflammatory markers and an acute kidney injury. Non-contrast CT kidney, ureters and bladder (KUB) revealed a 9 mm obstructing stone and prompt decompression with a JJ stent was performed. Although the urine culture showed no growth at first, an extended spectrum beta-lactamase was found in a subsequent urine culture after discharge. Postoperatively, the patient described a novel, worsening lower back pain and had persistently elevated inflammatory markers. An MRI revealed spondylodiscitis of L5/S1, for which she was treated with a 6-week course of antibiotics, and she has made a good but slow recovery. This case shows the unusual finding of spondylodiscitis postureteric stent placement and clinicians should be aware of this rare complication.
本病例报告描述了一位 70 多岁女性在因感染和梗阻性肾病行紧急输尿管支架置入术后出现的脊椎炎表现。该女性因右侧腰痛、炎症标志物升高和急性肾损伤就诊。非增强 CT 肾、输尿管和膀胱（KUB）显示有 9mm 梗阻性结石，立即行 JJ 支架置入术以进行快速减压。尽管最初尿液培养未见生长，但在出院后的后续尿液培养中发现了一种扩展谱β-内酰胺酶。术后，患者描述了一种新的、加重的下腰痛，且炎症标志物持续升高。MRI 显示 L5/S1 的脊椎炎，因此她接受了 6 周的抗生素治疗，目前恢复良好但较为缓慢。本病例显示了一种不常见的输尿管支架置入术后脊椎炎表现，临床医生应意识到这种罕见的并发症。
