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全脊柱外周:一种罕见且危及生命的疾病的多学科管理
Pedro Oliveira1, Maria E Batista1, Miguel Barbosa1
1Department of Critical Care Medicine, Hospital Curry Cabral, Unidade Local de Saúde de São José, Lisbon, PRT.
Cureus
|February 16, 2026
概括
一个罕见的泛脊柱外围,由甲素耐药黄金葡萄球菌在一个年轻的男性引起的病例,需要紧急手术和vancomycin. 及时诊断和多学科治疗导致神经恢复.
科学领域:
- 传染性疾病 传染性疾病
- 神经外科 神经外科
- 关键护理医学 关键护理医学
背景情况:
- 脊柱外围 (SEA) 是一种罕见但严重的感染.
- 泛脊柱干扰,从部延伸到圣骨区域,非常罕见,并与高发病率和死亡率有关.
- 静脉注射药物使用是SEA的重要危险因素.
研究的目的:
- 报告一个罕见的泛脊柱外围的病例.
- 突出广泛的SEA的诊断和管理挑战.
- 强调早期多学科干预的重要性.
主要方法:
- 一个28岁的男性病例报告,患有渐进式和呼吸困难.
- 磁共振成像 (MRI) 揭示了广泛的外周和脊柱旁.
- 通过手术排水进行分阶段的宫胸部和胸腔膜切除术.
- 静脉输入万科米辛治疗和高压氧气治疗.
- 对于残留的第二次手术排水.
主要成果:
- 发现的甲素耐药黄金葡萄球菌 (MRSA) 的性物质培养.
- 患者接受了分阶段的细叶切除术,并接受了向性抗生素治疗.
- 在8天后,神经恢复和输出管成功.
- 在综合治疗后,全脊柱外周完全消失.
结论:
- 早期识别和迅速,积极的多学科管理对于广泛的脊柱外围的良好结果至关重要.
- 需要高度的怀疑指数,特别是在具有风险因素的患者中,如静脉注射药物使用.
- 及时进行手术减压和排水,结合适当的抗生素治疗,对于预防严重的神经缺陷和死亡率至关重要.
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