Spinal epidural abscess due to coinfection of bacteria and tuberculosis:A case report  

作　　者：Choonghyo Kim Seungkoo Lee Jiha Kim 

机构地区：[1]Department of Neurosurgery,Kangwon National University School of Medicine,Chuncheon 24341,Gangwon,South Korea [2]Department of Neurosurgery,Kangwon National University Hospital,Chuncheon 24289,Gangwon,South Korea [3]Department of Anatomic Pathology,Kangwon National University School of Medicine,Chuncheon 24341,Gangwon,South Korea [4]Department of Anatomic Pathology,Kangwon National University Hospital,Chuncheon 24289,Gangwon,South Korea

出　　处：《World Journal of Clinical Cases》2021年第16期4072-4080,共9页世界临床病例杂志

摘　　要：BACKGROUND Spinal epidural abscess(SEA)is a rare condition that mostly results from infection with either bacteria or tuberculosis.However,coinfection with bacteria and tuberculosis is extremely rare,and it results in delays in diagnosis and antimicrobial treatment causing unfavorable outcomes.CASE SUMMARY A 75-year-old female visited the hospital with low back pain,and magnetic resonance imaging(MRI)revealed an SEA at the lumbosacral segment.Staphylococcus hominis and methicillin-resistant Staphylococcus epidermidis were identified from preoperative blood culture and intraoperative abscess culture,respectively.Thus,the patient underwent treatment with vancomycin medication for 9 wk after surgical drainage of the SEA.However,the low back pain recurred 2 wk after vancomycin treatment.MRI revealed an aggravated SEA in the same area in addition to erosive destruction of vertebral bodies.Second surgery was performed for SEA removal and spinal instrumentation.The microbiological study and pathological examination confirmed Mycobacterium tuberculosis as the pathogen concurrent with the bacterial SEA.The patient improved completely after 12 mo of antitubercular medication.CONCLUSION We believe that the identification of a certain pathogen in SEAs does not exclude coinfection with other pathogens.Tubercular coinfection should be suspected if an SEA does not improve despite appropriate antibiotics for the identified pathogen.

关 键 词：BACTEREMIA COINFECTION Epidural abscess TUBERCULOSIS Case report 

分 类 号：R52[医药卫生—内科学] R744[医药卫生—临床医学]