PDF(Pubmed)
Abstract：
BACKGROUND: Pyogenic spondylitis is often manifested as atypical low back pain and fever, which makes it easy to be confused with other diseases. Here we report a case of pyogenic spondylitis and describe the diagnosis and treatment based on the related literature.
METHODS: The reported case suffered from pyogenic spondylitis caused by Escherichia coli and complicated with bacteremia and psoas abscess. Acute pyelonephritis was initially diagnosed due to atypical symptoms. Symptoms were improved from antibiotic treatment while developing progressive lower limb dysfunction. One month post the admission, the patient underwent anterior lumbar debridement + autogenous iliac bone graft fusion + posterior percutaneous screw-rod internal fixation, and received 6 wk of antibiotic treatment after the operation. Reexamination 4 mo post the operation showed that the patient had no evident pain in the waist, and walked well with no evident dysfunction of lower limbs.
CONCLUSIONS: Here we describe the application value of several imaging examinations, such as X-ray, computed tomography and magnetic resonance imaging, and certain tests like erythrocyte sedimentation rate and C-reactive protein in the clinical treatment of pyogenic spondylitis. This disease requires early diagnosis and treatment. Sensitive antibiotics should be used in early stages and surgical intervention should be taken if necessary, which may help for a speedy recovery and prevent the occurrence of severe complications.
METHODS: The reported case suffered from pyogenic spondylitis caused by Escherichia coli and complicated with bacteremia and psoas abscess. Acute pyelonephritis was initially diagnosed due to atypical symptoms. Symptoms were improved from antibiotic treatment while developing progressive lower limb dysfunction. One month post the admission, the patient underwent anterior lumbar debridement + autogenous iliac bone graft fusion + posterior percutaneous screw-rod internal fixation, and received 6 wk of antibiotic treatment after the operation. Reexamination 4 mo post the operation showed that the patient had no evident pain in the waist, and walked well with no evident dysfunction of lower limbs.
CONCLUSIONS: Here we describe the application value of several imaging examinations, such as X-ray, computed tomography and magnetic resonance imaging, and certain tests like erythrocyte sedimentation rate and C-reactive protein in the clinical treatment of pyogenic spondylitis. This disease requires early diagnosis and treatment. Sensitive antibiotics should be used in early stages and surgical intervention should be taken if necessary, which may help for a speedy recovery and prevent the occurrence of severe complications.
摘要：
背景：化脓性脊柱炎常表现为不典型的下腰痛和发热，这很容易与其他疾病混淆。在此，我们报告一例化脓性脊柱炎，并根据相关文献描述诊断和治疗。
方法：1例大肠埃希菌所致化脓性脊柱炎并发菌血症和腰大肌脓肿。由于非典型症状，最初诊断为急性肾盂肾炎。抗生素治疗改善了症状，同时发展为进行性下肢功能障碍。入学后一个月，患者行腰椎前路清创+自体髂骨植骨融合+后路经皮钉棒内固定,术后6周接受抗生素治疗。术后4个月复查，患者腰部无明显疼痛，行走良好，下肢无明显功能障碍。
结论：这里我们描述了几种影像学检查的应用价值，比如X光,计算机断层扫描和磁共振成像，血沉、C反应蛋白等在化脓性脊柱炎临床治疗中的应用。这种疾病需要早期诊断和治疗。早期应使用敏感抗生素，必要时应采取手术干预，这可能有助于早日康复并防止严重并发症的发生。
方法：1例大肠埃希菌所致化脓性脊柱炎并发菌血症和腰大肌脓肿。由于非典型症状，最初诊断为急性肾盂肾炎。抗生素治疗改善了症状，同时发展为进行性下肢功能障碍。入学后一个月，患者行腰椎前路清创+自体髂骨植骨融合+后路经皮钉棒内固定,术后6周接受抗生素治疗。术后4个月复查，患者腰部无明显疼痛，行走良好，下肢无明显功能障碍。
结论：这里我们描述了几种影像学检查的应用价值，比如X光,计算机断层扫描和磁共振成像，血沉、C反应蛋白等在化脓性脊柱炎临床治疗中的应用。这种疾病需要早期诊断和治疗。早期应使用敏感抗生素，必要时应采取手术干预，这可能有助于早日康复并防止严重并发症的发生。
