Li Liang, Zhang Bao-Hua, Cao Jin-Feng, Zhang Li-Jin, Guo Ling-Ling
Department of Traditional Chinese Medicine, Zibo Central Hospital, Zibo 255000, Shandong Province, China.
Department of Pathology, Zibo Central Hospital, Zibo 255000, Shandong Province, China.
World J Clin Cases. 2024 Apr 26;12(12):2099-2108. doi: 10.12998/wjcc.v12.i12.2099.
The clinical incidence of spinal infection is gradually increasing, and its onset is insidious, easily leading to missed diagnosis and misdiagnosis, which may lead to serious complications such as nervous system dysfunction, spinal instability and/or deformity, and cause a huge burden on society and families. Early identification of the causative agent and precision medicine will greatly reduce the suffering of patients. At present, the main pathogenic bacteria that cause spinal infection are , Streptococcus, Pneumococcus, , and Klebsiella. There are no reports of spinal infection caused by .
We report a 32-year-old female patient with spinal infection. She presented with flank pain, initially thought to be bone metastases or bone tuberculosis, and had a family background of tumors. Her clinical features and changes in imaging and laboratory tests led to the suspicion of thoracic spine infection. Histopathology of the lesion showed inflammation, tissue culture of the lesion was negative several times, and the possible pathogen - was found after gene sequencing of the lesion. The patient recovered completely after a full course of antibiotic treatment.
This report increases the range of pathogens involved in spinal infections, highlights the unique advantages of gene sequencing technology in difficult-to-diagnose diseases, and validates conservative treatment with a full course of antibiotics for spinal infections without complications.
脊柱感染的临床发病率逐渐上升,其起病隐匿,易导致漏诊和误诊,可能引发神经系统功能障碍、脊柱不稳定和/或畸形等严重并发症,给社会和家庭带来巨大负担。早期识别病原体并进行精准治疗将极大减轻患者痛苦。目前,引起脊柱感染的主要病原菌有[具体病原菌1]、链球菌、肺炎球菌、[具体病原菌2]和克雷伯菌。尚无[具体病原菌3]引起脊柱感染的报道。
我们报告1例32岁脊柱感染女性患者。她以侧腹痛就诊,最初被认为是骨转移或骨结核,且有肿瘤家族史。其临床特征以及影像学和实验室检查结果变化引发了胸椎感染的怀疑。病变组织病理学显示炎症,病变组织培养多次阴性,经病变基因测序后发现可能的病原体——[具体病原体3]。患者经全程抗生素治疗后完全康复。
本报告增加了脊柱感染所涉及的病原体范围,突出了基因测序技术在疑难疾病诊断中的独特优势,并验证了对无并发症的脊柱感染采用全程抗生素的保守治疗方法。