PDF(Pubmed)
Abstract：
BACKGROUND: Andersen\'s lesion (AL) is a rare complication of ankylosing spondylitis (AS), characterized by nonneoplastic bone destruction, typically manifested as bone destruction and sclerosis in the vertebral body and/or intervertebral disc area. At present, there is no consensus on the pathology and etiology of AL. Repeated trauma, inflammation in essence and part of the natural history of Ankylosing spondylitis itself are the most widely recognized theories of the etiology of AL. However, positive bacteria cultured in bone biopsy of Andersen\'s lesion (AL) in Ankylosing spondylitis patients are extremely rare. Herein, we report a rare case of detecting Ewingella americana from a patient with Andersson lesion in ankylosing spondylitis by Metagenomic Next-Generation Sequencing (mNGS) Test.
METHODS: This case involved a 39-year-old male with a history of AS for 11 years, who developed AL (T11/12) in the thoracic vertebrae. After sufficient preoperative preparation, we successfully performed one-stage posterior approach corrective surgery and collected bone biopsies samples for examination. Cultured bacteria were not found, and pathological histology indicated infiltration of inflammatory cells. However, it is worth noting that we discovered a gram-negative bacterium, the Ewingella americana, through mNGS testing. Further histopathological examination suggests chronic inflammatory cell infiltration. After one-stage posterior approach corrective surgery, the patient\'s condition significantly improved. At the 6-month follow-up, the pain significantly decreased, and the patient returned to normal life.
CONCLUSIONS: We detected Ewinia americana in the bone biopsies of Andersson lesion (AL) in ankylosing spondylitis patient by mNGS.
METHODS: This case involved a 39-year-old male with a history of AS for 11 years, who developed AL (T11/12) in the thoracic vertebrae. After sufficient preoperative preparation, we successfully performed one-stage posterior approach corrective surgery and collected bone biopsies samples for examination. Cultured bacteria were not found, and pathological histology indicated infiltration of inflammatory cells. However, it is worth noting that we discovered a gram-negative bacterium, the Ewingella americana, through mNGS testing. Further histopathological examination suggests chronic inflammatory cell infiltration. After one-stage posterior approach corrective surgery, the patient\'s condition significantly improved. At the 6-month follow-up, the pain significantly decreased, and the patient returned to normal life.
CONCLUSIONS: We detected Ewinia americana in the bone biopsies of Andersson lesion (AL) in ankylosing spondylitis patient by mNGS.
摘要：
背景：安德森病变（AL）是强直性脊柱炎（AS）的罕见并发症，以非肿瘤性骨破坏为特征，通常表现为椎体和/或椎间盘区域的骨破坏和硬化。目前,关于AL的病理和病因尚无共识。反复的创伤,炎症本质上是强直性脊柱炎本身自然史的一部分，是AL病因学最广泛认可的理论。然而,在强直性脊柱炎患者中，在Andersen病变（AL）的骨活检中培养的阳性细菌极为罕见。在这里，我们报告了一例罕见的病例，通过宏基因组下一代测序（mNGS）检测从强直性脊柱炎Andersson病变患者中检测出美洲埃温格菌。
方法：该病例涉及一名39岁男性，有11年AS病史，在胸椎发展AL（T11/12）。经过充分的术前准备,我们成功地进行了一期后路矫正手术,并收集了骨活检样本进行检查.没有发现培养的细菌，病理组织学提示炎性细胞浸润。然而,值得注意的是，我们发现了一种革兰氏阴性细菌，美洲Ewingella,通过MNGS测试。进一步的组织病理学检查提示慢性炎症细胞浸润。一期后路矫正手术后,患者的病情明显改善。在6个月的随访中，疼痛明显减轻，病人恢复正常生活.
结论：我们通过mNGS在强直性脊柱炎患者Andersson病变（AL）的骨活检中检测到了美洲莫西氏菌。
方法：该病例涉及一名39岁男性，有11年AS病史，在胸椎发展AL（T11/12）。经过充分的术前准备,我们成功地进行了一期后路矫正手术,并收集了骨活检样本进行检查.没有发现培养的细菌，病理组织学提示炎性细胞浸润。然而,值得注意的是，我们发现了一种革兰氏阴性细菌，美洲Ewingella,通过MNGS测试。进一步的组织病理学检查提示慢性炎症细胞浸润。一期后路矫正手术后,患者的病情明显改善。在6个月的随访中，疼痛明显减轻，病人恢复正常生活.
结论：我们通过mNGS在强直性脊柱炎患者Andersson病变（AL）的骨活检中检测到了美洲莫西氏菌。
