Melo E Silva João, Oliveira Diogo, Louro João A, Monteiro Elisabete
Hospital de Vila Franca de Xira, Lisboa, Portugal.
Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal.
J Crit Care Med (Targu Mures). 2024 Apr 30;10(2):183-187. doi: 10.2478/jccm-2024-0020. eCollection 2024 Apr.
Rheumatoid arthritis, an inflammatory rheumatic disease predominantly affecting small limb joints, frequently compromises the cervical spine, resulting in spinal instability and the potential surgical necessity. This may result in severe complications, such as ventriculitis, often associated with a high mortality rate and multidrug-resistant organisms. A major challenge lies in achieving therapeutic antimicrobial concentrations in the central nervous system. The authors present a case of a 65-year-old female, with cervical myelopathy due to severe rheumatoid arthritis. Following surgery, the patient developed ventriculitis caused by an extensively drug-resistant . Early diagnosis and prompt treatment played a crucial role in facilitating neurological and cognitive recovery.
类风湿性关节炎是一种主要影响四肢小关节的炎性风湿性疾病，常累及颈椎，导致脊柱不稳定并可能需要进行手术。这可能会引发严重并发症，如脑室炎，常伴有高死亡率和多重耐药菌。一个主要挑战在于在中枢神经系统中达到治疗性抗菌浓度。作者介绍了一例65岁女性因严重类风湿性关节炎导致颈髓病的病例。手术后，患者发生了由广泛耐药菌引起的脑室炎。早期诊断和及时治疗对促进神经和认知功能恢复起到了关键作用。
