The 68th
Scientific Meeting
초록접수 미리보기
| 19S-053 |
Infectious spondylitis rapidly progressing in a short time : a case report
충남대학교 의과대학 마취통증의학교실
Introduction
Infectious spondylitis is a neurologically very dangerous condition and can be life threatening. There are various causes of infectious spondylitis such as pyogenic spondylitis, septic discitis, epidural abscess, and vertebral osteomyelitis. It is important to make the early diagnosis as early as possible through the patient\'s symptoms, radiological examination, and laboratory exam. Symptoms that may occur include weakness or paralysis, fecal control dysfunction, back pain, which may limit daily life or require continued analgesic medication. In most cases, non-surgical treatment is possible and some surgical treatment may be required.
Case report
A 50-year-old man without a history of special medical history was admitted to the pain clinic due to pain in the left shoulder and neck pain that started 3 weeks before. MRI performed at a local hospital showed no specific findings (Figure 1.) and was followed up without further treatment. Physical exam showed no abnormalities in the neck and shoulder joints. He said that he could not sleep because of severe pain. Trigger point injection and po medication such as NSAID and AAP with suspicion of myofascial pain syndrome due to severe pain when moving neck and shoulders. After one week, left chest pain was enlarged, and left arm numbness was newly appeared. When the symptoms are severe, the right arm is also numb. When he moves his arm or neck, the pain gets worse. His chest, back pain was too severe even with a slight touch. The pain is so severe that he can not sleep on the bed and sleep on the chair. There was no significant improvement in the use of medication, so he was admitted to hospital for further examination. CRP was increased but gradually decreased, and the possibility of infection was expected to be low. MRI performed 4 weeks after the onset of pain revealed infectious spondylitis C5 & C6 (Figure 2.). He wanted surgery and performed the operation.
Conclusion
If there is a sudden change in symptoms or an increase in severe pain, even if there was no abnormality at the last examination, it would be better to perform an active reexamination of additional lab and radiologic examinations such as MRI.
Reference
1. Young-Il Kim, Sung-Eun Kim, Hee Chang Jang. Analysis of the Clinical characteristics and Prognostic Factors of Infectious Spondylitis. Infect Chemother 2011: 43(1): 48-54
Infectious spondylitis is a neurologically very dangerous condition and can be life threatening. There are various causes of infectious spondylitis such as pyogenic spondylitis, septic discitis, epidural abscess, and vertebral osteomyelitis. It is important to make the early diagnosis as early as possible through the patient\'s symptoms, radiological examination, and laboratory exam. Symptoms that may occur include weakness or paralysis, fecal control dysfunction, back pain, which may limit daily life or require continued analgesic medication. In most cases, non-surgical treatment is possible and some surgical treatment may be required.
Case report
A 50-year-old man without a history of special medical history was admitted to the pain clinic due to pain in the left shoulder and neck pain that started 3 weeks before. MRI performed at a local hospital showed no specific findings (Figure 1.) and was followed up without further treatment. Physical exam showed no abnormalities in the neck and shoulder joints. He said that he could not sleep because of severe pain. Trigger point injection and po medication such as NSAID and AAP with suspicion of myofascial pain syndrome due to severe pain when moving neck and shoulders. After one week, left chest pain was enlarged, and left arm numbness was newly appeared. When the symptoms are severe, the right arm is also numb. When he moves his arm or neck, the pain gets worse. His chest, back pain was too severe even with a slight touch. The pain is so severe that he can not sleep on the bed and sleep on the chair. There was no significant improvement in the use of medication, so he was admitted to hospital for further examination. CRP was increased but gradually decreased, and the possibility of infection was expected to be low. MRI performed 4 weeks after the onset of pain revealed infectious spondylitis C5 & C6 (Figure 2.). He wanted surgery and performed the operation.
Conclusion
If there is a sudden change in symptoms or an increase in severe pain, even if there was no abnormality at the last examination, it would be better to perform an active reexamination of additional lab and radiologic examinations such as MRI.
Reference
1. Young-Il Kim, Sung-Eun Kim, Hee Chang Jang. Analysis of the Clinical characteristics and Prognostic Factors of Infectious Spondylitis. Infect Chemother 2011: 43(1): 48-54
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