Zhang Dan, Gan Li-Ying, Zhang Wen-Jie, Shi Ming, Zhang Liang, Zhang Yong, Liu Ming-Wei
Department of Orthopedics and Spine Surgery, Guangxi University of Traditional Chinese Medicine Affiliated International Zhuang Hospital, Nanning 530201, Guangxi Zhuang Autonomous Region, China.
Department of Clinical Laboratory, Guangxi University of Traditional Chinese Medicine Affiliated International Zhuang Hospital, Nanning 530201, Guangxi Zhuang Autonomous Region, China.
World J Orthop. 2024 Dec 18;15(12):1214-1225. doi: 10.5312/wjo.v15.i12.1214.
Cervical spine pyogenic infection (CSPI) is a rare and challenging form of spinal infection that is typically caused by pyogenic bacteria and primarily affects the cervical vertebral bodies and surrounding tissues. Given its nonspecific symptoms, such as fever and neck pain, early diagnosis is crucial to prevent severe complications, including spinal cord injury. We report a previously unreported case of acute CSPI arising from chronic paronychia, exploring its diagnostic and therapeutic challenges through a review of the current literature.
The presented case involved a 15-year-old man with CSPI caused by , which led to complications including bacteremia and a paronychia-associated abscess. Acute pyogenic infection was initially diagnosed by typical symptoms and blood culture. Fever improved after antibiotic treatment while developing progressive limbs dysfunction. Six days after admission, the patient underwent anterior cervical debridement + autogenous iliac bone graft fusion + plate internal fixation and received 12 weeks of antibiotic treatment after the operation. Re-examination 3 years postoperatively showed that the patient had stable cervical fixation, no significant neck pain or upper limb abnormalities, and normal urinary function.
Early imaging findings, laboratory markers, and timely antibiotic treatment are crucial for CSPI management, preventing complications and facilitating recovery.
颈椎化脓性感染（CSPI）是一种罕见且具有挑战性的脊柱感染形式，通常由化脓性细菌引起，主要影响颈椎椎体及周围组织。鉴于其非特异性症状，如发热和颈部疼痛，早期诊断对于预防包括脊髓损伤在内的严重并发症至关重要。我们报告一例先前未报道的由慢性甲沟炎引起的急性CSPI病例，并通过回顾当前文献探讨其诊断和治疗挑战。
该病例为一名15岁男性，患有由[具体病因未给出]引起的CSPI，导致包括菌血症和甲沟炎相关脓肿等并发症。急性化脓性感染最初通过典型症状和血培养确诊。抗生素治疗后发热有所改善，但出现进行性肢体功能障碍。入院6天后，患者接受了颈椎前路清创术+自体髂骨植骨融合术+钢板内固定，并在术后接受了12周的抗生素治疗。术后3年复查显示，患者颈椎固定稳定，无明显颈部疼痛或上肢异常，排尿功能正常。
早期影像学表现、实验室指标以及及时的抗生素治疗对于CSPI的管理至关重要，可预防并发症并促进康复。
