Emphysematous osteomyelitis of the spine A rare case report
Emphysematous osteomyelitis of the spine A rare case report
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DOI：
10.1097/md.0000000000021113
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发表时间：
2020-07-10
期刊：
影响因子：
1.6
通讯作者：
Kwon, Ji-Won
中科院分区：
文献类型：
--
作者：
Sung, Sahyun;Lee, Byung Ho;Kwon, Ji-Won
基本原理：肺气肿性骨髓炎是一种罕见的疾病引起的产气细菌。但从那时起，文献中只报道了45例。患者问题：一名72岁女性因4天前加重的严重下背痛来我院就诊。诊断：计算机断层扫描（CT）显示T12和L1椎体和硬膜外腔骨内有斑点状空气。增强T1和T2磁共振成像扫描显示椎体信号不均匀，提示气肿性骨髓炎。干预措施：进行手术以鉴定培养菌株，并使用广泛的经椎弓根冲洗去除椎体的气肿性病变。结果：在手术标本中鉴定出大肠杆菌，并继续使用头孢噻肟静脉内抗生素治疗。患者术后腰痛显著减轻，出院前最终CT扫描显示T12和L1椎体空气显著减少，硬膜外腔无空气密度。课程：我们报告一位大肠杆菌引起的脊椎气肿性骨髓炎，并成功地以手术治疗。
Rationale: Emphysematous osteomyelitis is a rare disease caused by gas-forming bacteria. But only 45 cases have been reported in the literature since then. Patient concerns: A 72-year-old female presented to our hospital with severe lower back pain that aggravated 4 days ago. Diagnoses: Computed tomography (CT) revealed intraosseous mottled air in the T12 and L1 vertebral bodies and epidural space. The enhanced T1 and T2 magnetic resonance imaging scans showed heterogeneous signal intensity of vertebral bodies, suggestive of emphysematous osteomyelitis. Interventions: Surgery was performed to identify culture strains and to remove emphysematous lesions of the vertebral body using extensive transpedicular irrigation. Outcomes: Escherichia coli (E coli)was identified in the surgical specimen, and intravenous antibiotic therapy was continued with cefotaxime. The patient had a significant decrease in lower back pain after the surgery and the final CT scan before discharge revealed significantly decreased air at T12 and L1 vertebral bodies and no air density in the epidural space. Lessons: We present a patient diagnosed with emphysematous osteomyelitis in vertebral bodies caused byE coliand successfully treated with surgical intervention.