一种罕见镰刀菌引起的胸椎真菌性骨髓炎伴压缩性脊髓病:一例报告

S. Raju, Chidambaram Muthu, Sudeep Reddy, Vinoth Thangamani, Bharat Kumar Ramalingam Jeyashankaran, Arunraj Sambandam
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摘要

背景:胸椎骨髓炎/脊椎椎间盘炎和脊髓硬膜外脓肿是罕见但危及生命的疾病,常见于免疫功能低下的人群。它需要早期发现和及时治疗,以避免晚期的后遗症和并发症。脓肿的病因可以是化脓性、结核性、真菌性或寄生性。念珠菌和曲霉菌是最常见的真菌原因,主要表现为免疫功能低下患者的椎间盘炎或骨髓炎,经血液传播。病例讨论:我们报告镰孢菌,一种机会性人类病原体,是人类皮肤菌群的正常共生菌,在这篇文章中,我们报告了一个60岁的健康男士,没有免疫功能低下阶段,胸椎骨髓炎合并硬膜外脓肿D9至D11,压迫性脊髓病和神经功能障碍的罕见病因。结论:除好氧、厌氧细菌和结核外,微生物学和组织病理学检查还应包括真菌检查。从组织中适当分离真菌是及时治疗和患者获得更好结果的必要条件。
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Thoracic Fungal Osteomyelitis with Compressive Myelopathy in an Immunocompetent Individual by a Rare Fusarium Species: A Case Report
Background: Thoracic vertebral osteomyelitis/spondylodiscitis and spinal epidural abscess are rare but life-threatening conditions, commonly seen in immunocompromised persons. It requires early detection and prompt management, to avoid late sequelae and complications. The cause for this abscess can be pyogenic, tuberculosis, fungal, or parasitic. Candida and Aspergillus species are the most common fungal causes which mainly present as discitis or osteomyelitis in the immunocompromised patient, after hematogenous dissemination. Case discussion: We report about Fusarium , an opportunistic human pathogen which is a normal commensal of human skin flora, in a 60-year- old healthy gentleman with no immunocompromised stage, the rare cause of thoracic vertebral osteomyelitis with epidural abscess D9 to D11 with compressive myelopathy and neurological deficit in this article. Conclusion: Along with aerobic, anaerobic bacterial and tuberculous, microbiological and histopathological investigations should also include fungal workup. Proper fungal isolation from the tissue is a must for prompt treatment and a better outcome for the patient.
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