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一名患有轻度新冠肺炎和金黄色葡萄球菌菌血症的成年男性的双侧肩部感染及椎间盘炎的延迟诊断:病例报告与文献综述

Bilateral Shoulder Infections and Delayed Recognition of Spinal Discitis in an Adult Male With Mild COVID-19 and Staphylococcus aureus Bacteremia: Case Report and Literature Review.

作者信息

Skedros John G, Montgomery Jessie A, Cronin John T, Richards Brett W, Curtis Kevin B, Matheu Michelle M, Mulcaire-Jones Mark

机构信息

Shoulder and Elbow, Utah Orthopaedic Specialists, Salt Lake City, USA.

Medical Education, University of Utah School of Medicine, Salt Lake City, USA.

出版信息

Cureus. 2024 Nov 29;16(11):e74765. doi: 10.7759/cureus.74765. eCollection 2024 Nov.

Abstract

Coronavirus disease 2019 (COVID-19) has been associated with numerous complications beyond the respiratory tract, including spinal and joint co-infections and secondary infections. However, we could not locate any reported cases of bilateral shoulder infections with additional spinal infections associated with mild (like our patient) COVID-19 or with more severe cases of COVID-19. We report the case of a healthy 62-year-old male who presented with mild COVID-19 and concurrent methicillin-sensitive (MSSA) bacteremia associated with multiple musculoskeletal sites of deep-seated infection. These included bilateral shoulder infections and delayed detection of lumbar spondylodiscitis with spinal epidural abscess (SEA). The patient had no known risk factors for complicated MSSA bacteremia. We discuss the potential pathophysiology and highlight the increased risk for worse outcomes in patients with mild COVID-19 and bacterial co-infections. This case is not only unique but provides valuable insight for physicians tasked with making difficult diagnoses that may be masked or complicated by COVID-19 infection.

摘要

2019冠状病毒病(COVID-19)除了会引发呼吸道并发症外,还与许多其他并发症相关,包括脊柱和关节合并感染以及继发感染。然而,我们未能找到任何关于双侧肩部感染并伴有与轻度COVID-19(如我们的患者)或更严重COVID-19病例相关的脊柱感染的报告病例。我们报告了一例62岁健康男性病例,该患者患有轻度COVID-19,并同时患有耐甲氧西林金黄色葡萄球菌(MSSA)菌血症,伴有多个肌肉骨骼部位的深部感染。这些感染包括双侧肩部感染以及腰椎间盘炎合并脊柱硬膜外脓肿(SEA)的延迟诊断。该患者没有已知的复杂MSSA菌血症风险因素。我们讨论了潜在的病理生理学,并强调了轻度COVID-19患者和细菌合并感染患者出现更差预后的风险增加。该病例不仅独特,而且为负责做出可能被COVID-19感染掩盖或复杂化的困难诊断的医生提供了有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4a5/11606536/a040c72713a9/cureus-0016-00000074765-i01.jpg

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