Fu Xu-Wen, Bi Yan, Wei Jia-Lu, Qi Min, Zhu Long, Pu Ying, Liu Jing-Liang, Li Xiang, Cun Xin-Hua
Department of Pharmacy, Kunming Third People's Hospital/Yunnan Clinical Medical Center for Infectious Diseases, Kunming, 650041, People's Republic of China.
Department of Radiology, The People's Hospital of Lincang, Lincang, 677000, People's Republic of China.
Infect Drug Resist. 2024 Oct 10;17:4349-4357. doi: 10.2147/IDR.S478117. eCollection 2024.
To observe the clinical characteristics of fungal and infections of the lumbar spine and explore the key points for their differential diagnosis.
The clinical data of 12 patients with fungal infection (the fungal group) and 31 patients with infection (the group) of the lumbar spine confirmed by microbiological culture and antigen test were retrospectively analysed. The differences in the clinical characteristics and imaging manifestations were observed between the two groups.
The peripheral blood neutrophil ratio, erythrocyte sedimentation rate, serum total protein and serum globulin levels in the fungal group were higher compared with the group, while the peripheral blood lymphocyte count, lymphocyte ratio and albumin-globulin ratio were lower in the fungal group compared with the group ( < 0.05). As for imaging examinations, the proportion of bone destruction centred on the intervertebral disc with surrounding osteosclerosis on computed tomography (CT) imaging showed a statistical difference between the group and the fungal group ( < 0.05). Fungal infection patients showed more osteosclerosis-free areas around the bone destruction on magnetic resonance imaging (MRI) than infection patients.
There are certain similarities in clinical manifestations between fungal and infections of the lumbar spine, but the haematological indices and image features of CT and MRI can effectively differentiate between them, providing guidance for the clinical differential diagnosis.
观察腰椎真菌及[此处原文缺失相关感染类型名称]感染的临床特征，探讨其鉴别诊断要点。
回顾性分析12例经微生物培养和抗原检测确诊的腰椎真菌感染患者（真菌组）和31例腰椎[此处原文缺失相关感染类型名称]感染患者（[此处原文缺失相关感染类型名称]组）的临床资料。观察两组临床特征及影像学表现的差异。
真菌组外周血中性粒细胞比例、红细胞沉降率、血清总蛋白和血清球蛋白水平高于[此处原文缺失相关感染类型名称]组，而真菌组外周血淋巴细胞计数、淋巴细胞比例和白蛋白球蛋白比值低于[此处原文缺失相关感染类型名称]组（P<0.05）。影像学检查方面，计算机断层扫描（CT）成像上以椎间盘为中心伴周围骨质硬化的骨质破坏比例在[此处原文缺失相关感染类型名称]组与真菌组之间存在统计学差异（P<0.05）。磁共振成像（MRI）显示，真菌感染患者骨质破坏周围无骨质硬化区域比[此处原文缺失相关感染类型名称]感染患者更多。
腰椎真菌及[此处原文缺失相关感染类型名称]感染在临床表现上有一定相似性，但血液学指标及CT和MRI的影像特征可有效鉴别二者，为临床鉴别诊断提供指导。
