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受感染的酸盐石头导致发热性脊髓炎和双侧下肢虚弱:一个病例报告
Cheng-Yang Wu1, Chi-Shin Tseng2, Yuan-Ju Lee2
1Department of Medical Education, National Taiwan University Hospital.
Annals of medicine and surgery (2012)
|October 9, 2023
概括
一个罕见的氧化部分角石的病例导致尿路感染和脊髓瘤炎. 迅速治疗包括抗生素,手术和石头去除,导致神经恢复和疾病根除.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
- 神经学 神经学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 氧化酸的结石通常发生在无菌的尿液中,很少引起尿路感染 (UTI).
- 与石头相关的尿路感染可能会导致诸如脊髓炎 (脊髓炎) 这样的并发症,脊髓感染会导致神经缺陷.
- 在当前的文献中,没有专门将酸盐部分鹿角石与脊髓瘤炎联系在一起的报道.
研究的目的:
- 报告一种罕见的脊髓炎病例,该病例是二次性氧酸盐部分鹿角石.
- 要突出这种罕见的临床表现的诊断和管理挑战.
- 强调及时干预的重要性,以获得有利的结果.
主要方法:
- 一名62岁的男性出现了尿路感染和侧肩疼痛的症状,被诊断为急性肺炎和左侧部分鹿角结石.
- 患者患有神经缺陷 (双边下肢虚弱) 归因于T2-T3脊髓瘤与脊髓压缩,由MRI证实.
- 治疗包括抗生素,脊柱的手术减压,皮肤透过的腎石切除术以去除石头,以及石头分析.
主要成果:
- 致病生物体Citrobacter koseri在尿液和外科创伤培养物中被发现.
- 经过手术和石头切除后,患者经历了显著的神经改善和尿路感染症状的消失.
- 组织病理学分析证实了石头的成分是氧酸盐.
结论:
- 这一案例强调了酸盐部分鹿角石可能导致严重的尿路感染和随后的血液传播导致脊髓瘤炎的可能性,尽管这种情况很少见.
- 早期诊断和多学科管理,包括抗生素,手术解压和石头根除,对于成功的患者康复至关重要.
- 这种罕见的并发症的成功治疗强调了在脊髓感染的差异诊断中考虑石头疾病的重要性,即使在最初存在看似无菌的尿液.
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