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腰椎骨髓炎并发硬脊膜外脓肿:1 例报告并文献复习。

Spondylodiscitis of lumbar complicated with spinal epidural abscess caused by : A case report and literature review.

机构信息

Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008.

Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha 410008.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 Dec 28;48(12):1929-1936. doi: 10.11817/j.issn.1672-7347.2023.230139.

Abstract

Spinal infection caused by () is a rare infection. The characteristic imageology includes spondylodiscitis, spondylitis, paravertebral abscess, and epidural abscess. One case of spondylodiscitis of lumbar complicated with spinal epidural abscess caused by was admitted to the Department of Spinal Surgery, Xiangya Hospital, Central South University on February, 2023. This case is a 60 years old man with lower back pain and left lower limb numbness. MRI showed spondylitis, spondylodiscitis, and epidural abscess. The patient underwent debridement, decompression and fusion surgery. The culture of surgical sample was negative. was detected by metagenomic next-generation sequencing (mNGS). The postoperative antibiotic treatment included intravenous infusion of linezolid and piperacillin for 1 week, then intravenous infusion of ceftazidime and oral metronidazole for 2 weeks, followed by oral metronidazole and nerofloxacin for 2 weeks. During the follow-up, the lower back pain and left lower limb numbness was complete remission. Spinal infection caused by is extremely rare, when the culture is negative, mNGS can help the final diagnosis.

摘要

由 引起的脊柱感染是一种罕见的感染。其特征性影像学表现包括椎间盘炎、脊椎炎、椎旁脓肿和硬膜外脓肿。2023 年 2 月,一名患有腰椎椎间盘炎合并硬膜外脓肿的患者被收入中南大学湘雅医院脊柱外科。该病例为 60 岁男性,表现为腰痛和左下肢麻木。MRI 显示脊椎炎、椎间盘炎和硬膜外脓肿。患者接受了清创、减压和融合手术。手术标本的培养结果为阴性。采用宏基因组下一代测序(mNGS)检测到 。术后抗生素治疗包括静脉滴注左氧氟沙星和哌拉西林 1 周,然后静脉滴注头孢他啶和口服甲硝唑 2 周,随后口服甲硝唑和诺氟沙星 2 周。随访期间,患者的腰痛和左下肢麻木完全缓解。由 引起的脊柱感染极为罕见,当培养结果为阴性时,mNGS 有助于明确最终诊断。

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本文引用的文献

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