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Cervical spondylodiscitis mimicking Pott's disease: a case report
G Gasparini1, M Mercurio, B Caroleo
1Department of Medical and Surgical Sciences, University Magna Græcia, Catanzaro, Italy. mercuriomi@gmail.com.
European Review for Medical and Pharmacological Sciences
|April 13, 2019
Summary
This case report highlights cervical spondylodiscitis, a rare cause of neck pain. Early diagnosis and conservative antibiotic treatment led to rapid symptom recovery in a patient with latent tuberculosis infection.
Area of Science:
- Infectious Diseases
- Neurology
- Radiology
Background:
- Pyogenic vertebral osteomyelitis, often caused by Staphylococcus aureus, is increasing, especially in the elderly.
- Cervical spondylodiscitis and epidural abscess can mimic other spinal infections like Pott's disease.
- This case presents a diagnostic challenge in differentiating spinal infections.
Observation:
- A 67-year-old male presented with severe neck pain, radiating pain, weakness, and paresthesia.
- MRI revealed C6-C7 contrast enhancement with abscess infiltration into the intervertebral disc, epidural space, and spinal cord.
- The patient had a history of a positive Mantoux test and a positive interferon-gamma release assay (IGRA) for latent tuberculosis.
Findings:
- Despite inconclusive tuberculosis diagnostics, the patient received intravenous antibiotics (teicoplanin and levofloxacin).
- The patient showed a rapid improvement in symptoms following antibiotic therapy.
- Cervical spondylodiscitis was the confirmed diagnosis, presenting atypically.
Implications:
- Cervical spondylodiscitis is an uncommon but significant cause of severe neck pain requiring careful differential diagnosis.
- Conservative management with antibiotics is effective for patients without neurological deficits.
- Close monitoring is crucial for patients undergoing conservative treatment for cervical spondylodiscitis.
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