DOI QR코드

DOI QR Code

Delayed Diagnosis of Tuberculous Spondylitis Masked by Concomitant Methicillin Resistant Staphylococcus Aureus Infection

  • Kim, Yong-Min (Department of Neurosurgery, Maryknoll Medical Center) ;
  • Cha, Jae-Hun (Department of Neurosurgery, Maryknoll Medical Center)
  • 투고 : 2009.07.10
  • 심사 : 2010.01.12
  • 발행 : 2010.03.28

초록

We present a case of tuberculous spondylitis in which diagnosis was masked by a concomitant pyogenic infection. The patient had undergone percutaneous needle aspiration of an abscess in the cavity of the psoas muscle. Early results from the culture regimen showed isolation of methicillin-resistant Staphylococcus aureus. After eight weeks, mycobacterium tuberculosis was grown at regimen which was cultured at the same site. Initial isolation of pyogenic bacteria, considered to be highly virulent organisms, led to delayed diagnosis and treatment of the tuberculosis.

키워드

참고문헌

  1. Babinchak TJ, Riley DK, Rotheram EB Jr : Pyogenic vertebral osteomyelitis of the posterior elements. Clin Infect Dis 25 : 221-224, 1997 https://doi.org/10.1086/514529
  2. Colmenero JD, JimEnez-MejIas ME, SAnchez-Lora FJ, Reguera JM, Palomino-Nicas J, Martos F, et al. : Pyogenic, tuberculous, and brucellar vertebral osteomyelitis: a descriptive and comparative study of 219 cases. ANN Rheum Dis 56 : 709-715, 1997 https://doi.org/10.1136/ard.56.12.709
  3. Joseffer SS, Cooper PR : Modern imaging of spinal tuberculosis. J Neurosurg Spine 2 : 145-150, 2005 https://doi.org/10.3171/spi.2005.2.2.0145
  4. Jung YJ, Kim SW, Chang CH, Kim SH, Kim OL, Cho SH : Prognostic factors of pyogenic spinal infections. J Korean Neurosurg Soc 38 : 445-449, 2005
  5. Kim SY, Hong SJ, Lee CY, Chung KB, Park CM : Tuberculous spondylitis versus pyogenic spondylitis : focusing on the discriminative MR findings for differentiation. J Korean Radiol Soc 56 : 183-189, 2007 https://doi.org/10.3348/jkrs.2007.56.2.183
  6. Klekamp JW, Green NE, Arildson RC : Paravertebral inflammation mistaken for neoplasm or abscess by MRI. J South Orthop Assoc 6 : 81-87, 1997
  7. Kotil K, Alan MS, Bilge T : Medical management of Pott disease in the thoracic and lumbar spine : a prospective clinical study. J Neurosurg Spine 6 : 222-228, 2007 https://doi.org/10.3171/spi.2007.6.3.222
  8. Meyer B, Schaller K, Rohde V, Hassler W : The C-reactive protein for detection of early infections after lumbar microdiscectomy. Acta Neurochir (Wien) 136 : 145-150, 1995 https://doi.org/10.1007/BF01410617
  9. Nussbaum ES, Rockswold GL, Bergman TA, Erickson DL, Seljeskog EL : Spinal tuberculosis : a diagnostic and management challenge. J Neurosurg 83 : 243-247, 1995 https://doi.org/10.3171/jns.1995.83.2.0243
  10. Osenbach RK, Hitchon PW, Menezes AH : Diagnosis and management of pyogenic vertebral osteomyelitis in adults. Surg Neurol 33 : 266-275, 1990 https://doi.org/10.1016/0090-3019(90)90047-S
  11. Pertuiset E, Beaudreuil J, Lioté F, Horusitzky A, Kemiche F, Richette P, et al. : Spinal tuberculosis in adults. A study of 103 cases in a developed country, 1980-1994. Medicine (Baltimore) 78 : 309-320, 1999 https://doi.org/10.1097/00005792-199909000-00003
  12. Quinones-Hinojosa A, Jun P, Jacobs R, Rosenberg WS, Weinstein PR : General principles in the medical and surgical management of spinal infections : a multidisciplinary approach. Neurosurg Focus 17 : E1, 2004

피인용 문헌

  1. Tuberculous Otitis Media and Staphylococcus aureus Coinfection in a Five-Year-Old Boy with Miliary Tuberculosis vol.5, pp.1, 2010, https://doi.org/10.4103/0974-777x.107171
  2. Clinical Outcome of Spinal Epidural Abscess in Elderly Patients vol.6, pp.2, 2010, https://doi.org/10.21129/nerve.2020.6.2.42
  3. Spinal epidural abscess due to coinfection of bacteria and tuberculosis: A case report vol.9, pp.16, 2010, https://doi.org/10.12998/wjcc.v9.i16.4072