PDF(Pubmed)
Abstract：
Odontoid osteomyelitis is a rare infectious disease that manifests as fever and posterior neck pain, while crowned dens syndrome is a relatively common inflammatory disorder with similar signs and symptoms. We describe the case of a 90-year-old woman presenting with fever, posterior neck pain, throat pain, and headache. Crowned dens syndrome was initially diagnosed based on the clinical picture and calcification around the odontoid process on cervical spine CT. However, the diagnosis was revised to odontoid osteomyelitis following the detection of Staphylococcus aureus in blood cultures that were performed due to the presence of headache. Infectious complications included spinal epidural abscess extending to the hypoglossal canal and osteomyelitis spreading to the clivus. Nonetheless, the patient achieved complete recovery after 13 weeks of antimicrobial therapy. No reports of odontoid osteomyelitis with calcification around the odontoid process have been reported. This case underscores the importance of avoiding a hasty diagnosis of crowned dens syndrome when calcification around the odontoid process is observed in patients presenting with fever and posterior neck pain. It is crucial to perform a thorough medical history review and physical examination to exclude other conditions. In cases where infection is suspected, blood cultures and cervical spine MRI are essential to investigate odontoid osteomyelitis and other complications.
摘要：
齿状骨髓炎是一种罕见的传染病，表现为发烧和颈后疼痛，而冠dens综合征是一种相对常见的炎症性疾病，具有相似的体征和症状。我们描述了一个90岁女性发烧的案例，颈后疼痛,喉咙疼痛,和头痛。根据颈椎CT上的临床表现和齿状突周围的钙化最初诊断为冠状窝综合征。然而,在血液培养物中检测到金黄色葡萄球菌后，由于头痛的存在，将诊断改为齿状突骨髓炎。感染性并发症包括脊髓硬膜外脓肿延伸到舌下管和骨髓炎扩散到斜坡。尽管如此，抗菌治疗13周后,患者完全康复.没有关于齿状突骨髓炎伴齿状突周围钙化的报道。此病例强调了在出现发烧和颈后疼痛的患者中观察到齿状突周围钙化时，避免仓促诊断冠状窝综合征的重要性。进行彻底的病史审查和体格检查以排除其他情况至关重要。在怀疑感染的情况下，血培养和颈椎MRI检查对于研究齿状突骨髓炎和其他并发症至关重要。
