Septic spondylodiscitis due to non-typhoidal Salmonella in a patient with rheumatoid arthritis treated with a TNF inhibitor and methotrexate.
Septic spondylodiscitis due to non-typhoidal Salmonella in a patient with rheumatoid arthritis treated with a TNF inhibitor and methotrexate.
复制标题
使用 TNF 抑制剂和甲氨蝶呤治疗的类风湿性关节炎患者因非伤寒沙门氏菌引起的化脓性脊椎椎间盘炎。
DOI：
10.1080/24725625.2017.1417673
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发表时间：
2017
影响因子：
0.8
通讯作者：
Otsuka T.
中科院分区：
文献类型：
--
作者：
Kawaguchi Y;Waguri-Nagaya Y; Oguri Y; Nozaki M; Kobayashi M; Otsuka T.
非伤寒沙门氏菌（NTS）是引起自限性胃肠炎的食源性感染的常见病原体。在此，我们报告了一个73岁的日本女性类风湿性关节炎（RA），其关节炎已得到良好的控制肿瘤坏死因子抑制剂，赛妥珠单抗（CTZ）聚乙二醇和甲氨蝶呤（MTX）的一年，由于NTS的脓毒性脊椎炎。病人高烧和背痛持续了一周。磁振造影（MRI）显示第9、10胸椎骨髓炎、腰椎炎伴椎旁脓肿。进行CT引导引流，抽吸物质培养物生长为NTS。成功的治疗与头孢曲松和持续引流导致病人的恢复。这是第一例脓毒性脊椎炎由于NTS在RA患者接受CTZ和MTX治疗。临床医生应该意识到接受免疫抑制治疗的患者有NTS感染的风险。
Non-typhoidalSalmonella(NTS) is a common pathogen causing foodborne infections that induce self-limiting gastroenteritis. Herein, we report a case of septic spondylodiscitis due to NTS in a 73-year-old Japanese female with rheumatoid arthritis (RA), whose arthritis had been well controlled by the tumour necrosis factor inhibitor, certolizumab (CTZ) pegol and methotrexate (MTX) for one year. The patient had been suffering from a high fever and back pain lasting one week. Magnetic resonance imaging (MRI) showed vertebral osteomyelitis and discitis of the 9th and 10th thoracic vertebrae with paravertebral abscess. CT-guided drainage was performed, and cultures of the aspirated material grew NTS. Successful treatment with ceftriaxone and continuous drainage led to the patient’s recovery. This is the first case of septic spondylodiscitis due to NTS in an RA patient treated with CTZ and MTX. Clinicians should be aware that patients on immunosuppressive therapy have a risk of NTS infection.