颈椎布鲁氏菌脊柱炎:关于诊断和手术治疗的病例报告。

IF 2.9 3区 医学 Q2 INFECTIOUS DISEASES Infection and Drug Resistance Pub Date : 2024-08-14 eCollection Date: 2024-01-01 DOI:10.2147/IDR.S474589
Bo Liu, Yao Zhang, Zheng Yuan, Qiang Zhang
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引用次数: 0

摘要

背景:布鲁氏菌病是一种人畜共患病,可影响包括脊柱在内的多个器官。由布鲁氏菌引起的颈椎炎非常罕见,但如果不及时诊断和治疗,会导致严重的发病率:我们报告了一例 46 岁女性的病例,她出现间歇性高烧和顽固性颈、肩和背部疼痛两个月。根据临床表现、玫瑰-孟加拉平板凝集试验(RBPT,阳性)和颈椎磁共振成像结果,她被诊断为布鲁氏杆菌颈椎炎。她接受了至少两周的联合抗生素治疗,随后接受了手术治疗,包括脓肿清除、部分椎体切除和钛网骨融合术。实时聚合酶链反应(RT-PCR)证实了羊布鲁氏杆菌 DNA 的存在。患者术后恢复良好,疼痛明显减轻,右上肢恢复了完全活动能力:本病例凸显了 RT-PCR 和组织活检在颈部布鲁氏菌脊柱炎中的诊断价值。我们的研究发现,前路颈椎次全椎体切除术可在药物治疗的基础上恢复颈椎稳定性、清除脓肿、解除脊髓压迫,临床效果良好。
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Cervical Brucella Spondylitis: A Case Report on Diagnosis and Surgical Management.

Background: Brucellosis is a zoonotic disease that can affect various organs, including the spine. Cervical spondylitis caused by Brucella is rare but can lead to significant morbidity if not diagnosed and treated promptly.

Case presentation: We report a case of a 46-year-old female who presented with intermittent high fever and intractable neck, shoulder, and back pain for two months. She was diagnosed with Brucella cervical spondylitis based on clinical manifestations, Rose-Bengal Plate Agglutination Test (RBPT, positive), and cervical MRI findings. She was treated with a combination of antibiotics for at least two weeks, followed by surgical intervention including abscess clearance, partial vertebral resection, and titanium mesh bone fusion. Real-time Polymerase Chain Reaction (RT-PCR) confirmed the presence of sheep Brucella DNA. The patient recovered well postoperatively with significant pain reduction and restoration of full mobility in the right upper limb.

Conclusion: This case highlights the diagnostic value of RT-PCR and tissue biopsy in cervical brucellosis spondylitis. Our study found that anterior cervical subtotal corpectomy can restore cervical stability, clear abscess, and relieve spinal cord compression on the basis of drug treatment, with good clinical results.

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来源期刊
Infection and Drug Resistance
Infection and Drug Resistance Medicine-Pharmacology (medical)
CiteScore
5.60
自引率
7.70%
发文量
826
审稿时长
16 weeks
期刊介绍: About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.
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