Spontaneous emphysematous osteomyelitis of the spine: A case report.
Spontaneous emphysematous osteomyelitis of the spine: A case report.
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DOI：
10.1016/j.radcr.2020.05.078
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发表时间：
2020-09
影响因子：
--
通讯作者：
Muccio CF
中科院分区：
文献类型：
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作者：
Di Stasi M;Pontillo G;Bartolini A;Elefante A;Muccio CF
自发性肺气肿性骨髓炎的脊柱是一种非常罕见的，但严重的条件所造成的气体形成的微生物。我们报告一例41岁肥胖男性患者，因糖尿病酮症酸中毒、发热和行走困难在急诊室就诊。脊柱的计算机断层扫描和磁共振成像显示骨髓水肿和第四和第五腰椎异节水平的骨内气体聚集，表明由产气微生物维持的骨髓炎，然后通过在血培养中分离出肺炎克雷伯氏菌来证实。影像学检查在肺气肿性骨髓炎的诊断中起着重要作用：骨内多处不同大小的气体聚集，特别是在有特定危险因素的患者中，高度提示由产气病原体引起的感染。熟悉这种特殊的神经放射学表现是必要的，以确保早期诊断和及时的抗菌治疗，这可以大大改善预后。
Spontaneous emphysematous osteomyelitis of the spine is a very rare but severe condition caused by gas-forming microorganisms. We present the case of a 41-year-old obese male patient presenting at the Emergency Department with diabetic ketoacidosis, fever, and difficulty in walking. computed tomography and magnetic resonance imaging of the spine revealed bone marrow edema and intraosseous gas collections at the level of the fourth and fifth lumbar metameres, suggesting an osteomyelitis sustained by gas-forming microorganisms, which was then confirmed by the isolation of Klebsiella pneumonia in blood culture. Imaging plays a central role for the diagnosis of emphysematous osteomyelitis: the presence of multiple intraosseous gas collections of variable size, especially in patients with specific risk factors, is highly suggestive of an infection caused by gas-forming pathogens. Being familiar with this peculiar neuroradiological appearance is essential to ensure an early diagnosis and a timely antimicrobial therapy, which can considerably ameliorate the prognosis.