İmmünkompetan hastada primer nokardiyal vertebra osteomiyeliti
Yükleniyor...
Dosyalar
Tarih
2015
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Nokardiya türleri, immünsüpresif hastalarda vertebral osteomiyelitin nadir bir sebebidir ve literatürde bildirilmiş az sayıda olgu bulunmaktadır. Nokardiyoz genellikle akciğerlerden orijin alan, beyin gibi diğer organlara yayılma eğiliminde olan kronik bakteriyel bir infeksiyondur. Bu makalede pulmoner tutulumu olmayan, immünkompetan bir primer nokardiyal vertebra osteomiyeliti olgusu sunulmuştur. Olguda bir buçuk yıl önce başlayan bel ağrısı ve spinal hareketlerde kısıtlılık yakınmaları saptanmıştır. L2 vertebra, paraspinal bölge ve psoas kası içerisinde saptanan multiple apseleri cerrahi ve medikal tedaviye rağmen tekrarlamıştır. Operasyon bölgesindeki akıntıdan alınan materyalin kültüründe 3. günde Nocardia spp. izole edilmiştir. Tür tayini yapılamadığından trimetoprim sülfametoksazol, meropenem ve amikasin ile üçlü kombinasyon tedavisi başlanmıştır. Tedavinin 7. gününde operasyon bölgesindeki akıntı kesilmiştir. Hastada apselerin cerrahi drenajı, L2 vertebra korpusu eksizyonu ve uygun medikal tedavi sonrasında kontrol lomber vertebra MR’larında apse görülmemiştir. Bu olgu, tüberküloz ve brusellozun dışlandığı granülomatöz vertebral osteomyelit olgularında Nokardiya türlerinin de olası patojenlerden biri olabileceğini vurgulamak amacıyla paylaşılmıştır.
Nocardia spp., is a rare cause of vertebral osteomyelitis in patients with immunosuppression and there are few cases have been reported in the literature. Nocardia infection is a chronic bacterial infection that usuall originates from the lungs which tends to spread to other organs such as the brain. A case of primary nocardial vertebral osteomyelit is with no history of immunosuppression and pulmoner involvement is presented in this article. She was complaining of back pain and limitati- on of spinal movement. Her complaints have been going on for 1.5 years. Multiple abscesses which were detected in the L2 vertebrae, paraspinal region and psoas muscle repeated despite surgical and medical treatment. Nocardia spp. was isolated on the third day. Because of subspecies of nocardia can not be determined, triple combination therapy with trimethoprim sulfa - methoxazole, meropenem and amikacin was started. Seventh day of treatment, discharge from operation region was stopped. After surgical drain age of the abscesses, excision of the L2 vertebral body and appropriate medical treatment, control lumbar spine MRI showed no abscess. This case was shared to highlight that Nocardia spp. should be one of the potential pathogen in the cases of granulomatous vertebral osteomyelitis in whom tuberculosis and brucellosis has been excluded.
Nocardia spp., is a rare cause of vertebral osteomyelitis in patients with immunosuppression and there are few cases have been reported in the literature. Nocardia infection is a chronic bacterial infection that usuall originates from the lungs which tends to spread to other organs such as the brain. A case of primary nocardial vertebral osteomyelit is with no history of immunosuppression and pulmoner involvement is presented in this article. She was complaining of back pain and limitati- on of spinal movement. Her complaints have been going on for 1.5 years. Multiple abscesses which were detected in the L2 vertebrae, paraspinal region and psoas muscle repeated despite surgical and medical treatment. Nocardia spp. was isolated on the third day. Because of subspecies of nocardia can not be determined, triple combination therapy with trimethoprim sulfa - methoxazole, meropenem and amikacin was started. Seventh day of treatment, discharge from operation region was stopped. After surgical drain age of the abscesses, excision of the L2 vertebral body and appropriate medical treatment, control lumbar spine MRI showed no abscess. This case was shared to highlight that Nocardia spp. should be one of the potential pathogen in the cases of granulomatous vertebral osteomyelitis in whom tuberculosis and brucellosis has been excluded.
Açıklama
Anahtar Kelimeler
Farmakoloji ve Eczacılık
Kaynak
ANKEM Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
29
Sayı
1
