一个混背部疼痛的案例
Cedric A Green1, Lydia Mbatidde2, Jehan R Shah1
1Department of Family Medicine, Mayo Clinic, Jacksonville, FL, USA.
The American journal of case reports
|June 12, 2023
概括
剧烈的背部疼痛可能是脊椎骨髓炎等严重疾病的信号,特别是红旗症状. 早期,彻底的评估对于及时诊断和有效的治疗来预防并发症至关重要.
科学领域:
- 内部医学 内部医学
- 传染性疾病 传染性疾病
- 放射学 放射学是一门学科.
背景情况:
- 急性背痛在初级保健中非常普遍,影响超过60%的个人.
- 发烧或神经缺陷等红旗迹象需要进一步调查.
研究的目的:
- 为了呈现脊椎骨质炎的病例,该病例是尿路感染的次要原因.
- 强调广泛差异诊断的重要性,并认识到背部疼痛患者的红旗症状.
主要方法:
- 一份病例报告显示,一名70岁的男性患有多抗药性大肠杆菌尿路感染导致的败血症后的胸中背部疼痛.
- 由于持续的症状,进行初始的保守管理,随后进行高级成像 (MRI,CT导向活检).
- 诊断的T7-T8骨髓炎和脑膜炎通过活检证实透露多药性耐药性大肠杆菌.
主要成果:
- 磁共振成像揭示了T7-T8骨髓炎和椎间盘炎,其中涉及脊周软组织.
- 计算机断层扫描指导的活检证实了多抗药性大肠杆菌,表明最近尿路感染的血液性传播.
- 治疗涉及8周的静脉注射埃尔塔胺.
结论:
- 在患有急性背痛和红旗症状的患者中,保持对脊椎骨质炎的高怀疑指数至关重要.
- 综合性评估,适当的调查和密切的随访对于及时诊断和管理脊椎骨髓炎至关重要,以防止并发症.
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