Τίτλος:
Multifocal spinal and extra-spinal Mycobacterium chelonae osteomyelitis
in a renal transplant recipient
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Only localized cases of Mycobacterium chelonae osteomyelitis have been
reported. In this article, a 55-year-old immunosuppressed man with M.
chelonae osteomyelitis and multiple spinal and extra-spinal involvement
is presented. The patient had nodulo-pustular skin lesions,
spondylodiscitis at multiple levels, and osteolytic lesions at
extra-spinal locations. Biopsy and cultures of the osseous lesions
showed M. chelonae osteomyelitis. The patient started antimycobacterial
chemotherapy with ciprofloxacin and clarithromycin. Progressive cervical
kyphosis associated with anterior wedged deformity of the C5 vertebra
and posterior C5-C6 spondylolisthesis resulted in compression of the
spinal cord and neurological impairment. The patient underwent anterior
decompression and C4-C6 arthrodesis using a titanium mesh cage and
cervical plate. About 15 months after the initiation of chemotherapy and
5 months after surgery, the patient was pain free, with significant
improvement of his neurological function. In the presence of
immunosuppression, the physician should be alert for unusual or
opportunistic pathogens of osteomyelitis. Long-term antimicrobial
chemotherapy and surgical intervention is the cornerstone of successful
treatment of multifocal bone M. chelonae infection.
Συγγραφείς:
Korres, D. S.
Papagelopoulos, P. J.
Zahos, K. A.
Kolia, M.
D.
Poulakou, G. G.
Falagas, M. E.
Περιοδικό:
Transplant Infectious Disease
Εκδότης:
Blackwell Publishing Inc.
Λέξεις-κλειδιά:
Mycobacterium chelonae; osteomyelitis; magnetic resonance imaging;
spinal infections; spondylodiscitis; immunosuppression; corticosteroid
therapy; organ transplantation
DOI:
10.1111/j.1399-3062.2006.00178.x
