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脊柱包虫病:一例病例报告——低收入和中等收入国家中一种罕见的鉴别诊断。

Spinal hydatid disease: a case report - an uncommon differential diagnosis in LMICs.

作者信息

Avetis A Kirakosyan, Emma S Maghakyan, Chavda Vishal, Chaurasia Bipin

机构信息

Department of Neurosurgery, Astghik MC, Yerevan, Armenia.

Department of Medicine, Multispecialty, Trauma and ICCU Centre, Sardar Hospital, Gujarat, India.

出版信息

Ann Med Surg (Lond). 2024 Oct 24;86(12):7423-7426. doi: 10.1097/MS9.0000000000002691. eCollection 2024 Dec.

Abstract

BACKGROUND AND IMPORTANCE

With a 0.2-1% incidence, spinal hydatid disease is a very uncommon diagnosis. While it is uncommon in affluent nations, it should be taken into account when making a differential diagnosis for spinal cord compression syndrome, particularly in regions where it is prevalent.

CASE PRESENTATION

The authors report a case of hydatid illness of the spine. A 52-year-old man presented with lower extremity discomfort and spastic paraparesis, trouble urinating, and back pain and edema. He had at the level of the 12th thoracic to third lumbar vertebrae (Th12-L3) with paraspinal extension. The patient was treated with 4 months of antiparasitic therapy and two surgical resections performed by general surgeons. Histological analysis showed pieces of fibrous tissue exhibiting granulomatous inflammation; however, no evidence of acid-resistant bacteria or PAS-positive chitin membrane was found. The existence of bacteria following therapy has not been confirmed by the parasitological investigation of the lesions.

CLINICAL DISCUSSION

Primary spinal hydrodatidosis is a rare condition that affects about 0.2-1% of the population.

CONCLUSION

Due to the rarity of this disease, early discovery and timely treatment are critical, and this diagnosis should be considered when generating a differential diagnosis for spinal cord compression syndrome.

摘要

背景与重要性

脊柱包虫病发病率为0.2%-1%,是一种非常罕见的诊断。虽然在富裕国家不常见,但在对脊髓压迫综合征进行鉴别诊断时应予以考虑,特别是在该病流行的地区。

病例介绍

作者报告一例脊柱包虫病病例。一名52岁男性出现下肢不适、痉挛性截瘫、排尿困难以及背痛和水肿。病变位于第12胸椎至第3腰椎水平(Th12-L3)并向椎旁延伸。患者接受了4个月的抗寄生虫治疗,并由普通外科医生进行了两次手术切除。组织学分析显示纤维组织碎片呈现肉芽肿性炎症;然而,未发现抗酸菌或PAS阳性几丁质膜的证据。病变的寄生虫学检查未证实治疗后细菌的存在。

临床讨论

原发性脊柱包虫病是一种罕见疾病,影响约0.2%-1%的人群。

结论

由于这种疾病罕见,早期发现和及时治疗至关重要,在对脊髓压迫综合征进行鉴别诊断时应考虑到这种诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30fb/11623898/0cb84f9e8d10/ms9-86-7423-g001.jpg

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