PDF(Pubmed)
Abstract：
Blastomycosis infection is caused by the inhalation of the spores of the dimorphic Blastomyces sp.fungus. While more commonly a self-limited infection of the lungs, extrapulmonary manifestations arise from hematogenous or contiguous spread. Disseminated infection most often includes skin lesions and osteomyelitis; however, central nervous system (CNS) involvement is infrequently reported in the literature. Herein, we present a case of a retropharyngeal blastomycosis abscess leading to cervical spine osteonecrosis with retropulsion, deformity, and a spinal epidural abscess, and we discuss the relevant literature. The patient was successfully treated with cervical traction, followed by a combined anterior-posterior cervical approach, including abscess drainage, corpectomies, and instrumented fixation. Postoperatively, the patient completed 12 months of voriconazole and had near resolution of preoperative symptoms. Expediting neurosurgical intervention, such as the utilization of decompression, the clearance of infectious burden, and the correction of alignment, is critical for preventing downstream complications. Retropharyngeal blastomycosis abscesses are rare, and we report one of the rare instances of dissemination to and the degeneration of the cervical spine.
摘要：
芽生菌病感染是由吸入双形芽孢子引起的。真菌。虽然更常见的是自我限制的肺部感染，肺外表现是由血源性或连续传播引起的。播散性感染最常包括皮肤损伤和骨髓炎；然而，文献中很少报道中枢神经系统（CNS）受累。在这里，我们介绍了一例咽后胚菌病脓肿导致颈椎骨坏死的后推进，畸形,和脊髓硬膜外脓肿,我们讨论了相关的文献。患者经颈椎牵引治疗成功,然后是颈椎前后路联合入路，包括脓肿引流,尸体解剖,和仪器固定。术后,患者完成了12个月的伏立康唑治疗,术前症状基本缓解.加快神经外科干预，例如减压的利用，清除传染病负担，和校正对准，对于预防下游并发症至关重要。咽后胚生菌病脓肿很少见，我们报告了一种罕见的颈椎扩散和退化的情况。
