Abstract：
Patient 1 was a 70-year-old woman with refractory diffuse large B-cell lymphoma who received allogeneic peripheral blood stem cell transplantation from an HLA-haploidentical related donor. Upper back pain appeared on day63, and Th8-Th9 pyogenic spondylitis was diagnosed based on magnetic resonance imaging (MRI). Blood culture on day14 identified Corynebacterium striatum as the causative bacteria of blood stream infection (BSI). The pyogenic spondylitis resolved after treatment with daptomycin for 2 months. Patient 2 was a 65-year-old man with relapsed angioimmunoblastic T-cell lymphoma who received bone marrow transplantation from an HLA-DR single-antigen-mismatched unrelated donor. Lower back pain appeared on day30, and L4-L5 pyogenic spondylitis was diagnosed based on MRI. Blood culture was negative. Daptomycin and clindamycin were selected for treatment based on the drug susceptibility of bacteria that had caused pre-engraftment BSI (Escherichia coli on day3 and Corynebacterium striatum on day9), and the pyogenic spondylitis resolved after 6 months of this treatment. Pyogenic spondylitis should be considered in the differential diagnosis of back pain accompanied by BSI before engraftment in allogeneic hematopoietic stem cell transplant recipients.
摘要：
患者1是患有难治性弥漫性大B细胞淋巴瘤的70岁女性,其接受来自HLA-单倍体相关供体的同种异体外周血干细胞移植。第63天出现上背部疼痛，并根据磁共振成像（MRI）诊断出Th8-Th9化脓性脊柱炎。第14天的血液培养将纹状体棒杆菌鉴定为血流感染（BSI）的致病菌。化脓性脊柱炎在达托霉素治疗2个月后缓解。患者2是一名65岁的男性，患有复发性血管免疫母细胞T细胞淋巴瘤，他接受了HLA-DR单抗原不匹配的无关供体的骨髓移植。第30天出现下背痛，根据MRI诊断L4-L5化脓性脊柱炎。血培养为阴性。根据引起植入前BSI的细菌（第3天的大肠杆菌和第9天的纹状体棒状杆菌）的药物敏感性，选择达托霉素和克林霉素进行治疗。化脓性脊柱炎在这种治疗6个月后消退。在异基因造血干细胞移植受者植入前伴BSI的背痛的鉴别诊断中应考虑化脓性脊柱炎。
