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性胸痛作为发热性脊髓炎的初始表现
Keisuke Kuroda1, Hirofumi Nakazaki1, Yuri Shibata2
1Department of Respiratory Medicine, Tottori Red Cross Hospital, Tottori, JPN.
Cureus
|May 19, 2025
概括
发烧性脊柱炎最初可以呈现为胸腔性胸痛,模仿细菌性胸膜炎. 这一案例凸显了在患有不明原因的胸痛和发烧的患者中考虑脊髓感染的重要性.
科学领域:
- 传染性疾病 传染性疾病
- 整形外科手术 整形外科手术
- 肺部病理学 肺部病理学
背景情况:
- 发烧性脊柱炎 (脊柱感染) 通常会导致背痛,发烧和疲劳.
- 胸部多发性疼痛是发性脊髓炎的一个非典型症状.
研究的目的:
- 报告一种罕见的发烧性脊髓炎病例,最初呈现为胸部多发性疼痛.
- 强调脊髓感染的非典型表现所带来的诊断挑战.
- 为了突出 pyogenic 脊髓炎可能导致二次性肺炎的潜力.
主要方法:
- 一个62岁的男性病例报告,胸部有多发性疼痛和发烧.
- 最初的诊断工作包括胸部CT显示胸部溢液.
- 随后的调查包括在初始治疗失败后的血液培养和胸脊MRI.
主要成果:
- 患者最初接受了细菌性肺炎治疗,但没有改善.
- 血液培养物检测出有甲素耐药黄金葡萄球菌 (MRSA) 的阳性.
- 胸脊MRI证实了带有脊椎腹和胸腔炎炎的炎症性脊髓炎.
结论:
- 发烧性脊柱炎可以表现为胸部多发性疼痛,这是由于感染的连续传播.
- 临床医生应考虑在无法解释或持久性多炎的情况下,特别是与黄金杆菌菌菌的病例中考虑发热性脊髓炎.
- 及时识别和适当的成像对于诊断异常呈现的脊髓感染至关重要.
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