Abstract：
Background: The incidence of pyogenic spondylodiscitis has been increasing in countries of Europe and North America, probably due to an increasing number of persons with risk factors for this infection. It is unclear whether HIV infection in the era of antiretroviral therapy (ART) increases the risk for spondylodiscitis. Method: We present 7 cases of pyogenic spondylodiscitis of the cervical, thoracic, and lumbar spine in six individuals living with HIV under ART with suppressed viral load. Results: All patients presented with severe non-radicular pain and elevated inflammatory markers. Diagnosis was confirmed by magnetic resonance imaging (MRI) scan and isolation of the pathogen. Staphylococcus aureus was the causative pathogen in five patients. One patient suffered from an infection with Klebsiella pneumoniae followed by a mixed infection with Cutibacterium acnes and Bacillus circulans 18 months later. All patients needed surgical intervention, and the mean duration of antibiotic treatment was 17 weeks (range 12-26). Five patients recovered fully, including two persons who also suffered from endocarditis. One patient died from multi-organ failure. Conclusion: Spondylodiscitis may be seen more frequently in persons living with HIV as they grow older and suffer from comorbidities which put them at risk for this infection. HIV physicians should be aware of the infection and its risk factors.
摘要：
背景：化脓性脊椎盘炎的发病率在欧洲和北美国家一直在增加，可能是由于越来越多的人有这种感染的危险因素。目前尚不清楚抗逆转录病毒治疗（ART）时代的HIV感染是否会增加脊柱盘炎的风险。方法：我们介绍了7例化脓性颈椎椎间盘炎，胸廓,在抗逆转录病毒治疗下，六名艾滋病毒感染者的腰椎和腰椎病毒载量受到抑制。结果：所有患者均表现为严重的非神经根性疼痛和炎症标志物升高。通过磁共振成像（MRI）扫描和病原体的分离证实了诊断。金黄色葡萄球菌是5例患者的病原体。一名患者患有肺炎克雷伯菌感染，然后在18个月后与痤疮杆菌和循环芽孢杆菌混合感染。所有患者都需要手术干预，抗生素治疗的平均持续时间为17周（范围12-26）。五名病人完全康复,包括两名也患有心内膜炎的人。一名患者死于多器官衰竭。结论：在HIV感染者中，随着年龄的增长和合并症的发生，脊椎盘炎的发生率更高，这使他们面临感染的风险。HIV医生应了解感染及其危险因素。
