感染性特应性湿疹并发金黄色葡萄球菌化脓性脊髓感染导致脊髓损伤:两例报告。

IF 0.7 Q4 CLINICAL NEUROLOGY
K MacKay, E J McCaughey, N Fullerton, M Purcell
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引用次数: 0

摘要

导言:化脓性脊柱感染(PSI)是脊髓损伤(SCI)的罕见病因。最常见的感染部位是腰椎,其次是胸椎,最不常见的是颈椎,最常见的致病菌是金黄色葡萄球菌。特应性湿疹是一种皮肤病,可导致皮肤的天然屏障功能被破坏,从而导致细菌定植和感染。从远处感染源(包括皮肤和软组织)进行血液学细菌播种是 PSI 的公认病因:我们介绍了两名因特异性湿疹继发 PSI 而导致 SCI 的患者。两名患者的致病菌均为对甲氧西林敏感的金黄色葡萄球菌(MSSA)。这两名患者需要长期静脉注射抗生素,然后再口服抗生素。两名患者的神经系统结果各不相同。其中一名患者为不完全四肢瘫痪(C3 AIS C),出院时需要从床上抬到电动椅上,留置尿道导尿管,并需要肠道护理。另一名患者为不完全截瘫(L3 AIS D),出院时能独立进行日常生活活动,并能使用双肘拐杖移动:我们认为,这里介绍的两个病例是已发表文献中唯一一个二次感染特应性湿疹导致 PSI 并导致 SCI 的病例。由于 SCI 是一种严重且可能影响生命的并发症,因此治疗特应性湿疹患者的医务人员应了解这一风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Spinal cord injury as a result of Staphylococcus aureus pyogenic spinal infection complicating infected atopic eczema: two case reports.

Spinal cord injury as a result of Staphylococcus aureus pyogenic spinal infection complicating infected atopic eczema: two case reports.

Introduction: Pyogenic spinal infections (PSI) are a rare cause of spinal cord injury (SCI). These most often affect the lumbar spine, followed by the thoracic spine and least commonly the cervical spine, with Staphylococcus aureus being the most common causative organism. Atopic eczema is a dermatological condition which can lead to a breakdown of the skin's natural barrier function, allowing bacterial colonisation and infection. Haematological seeding of bacteria from a distant source of infection, including the skin and soft tissues, is a recognised aetiology of PSI.

Case presentation: We present two patients who sustained a SCI as a result of PSI secondary to infected atopic eczema. Methicillin-sensitive Staphylococcus aureus (MSSA) was identified as the causative organism in both patients. The two patients required prolonged courses of intravenous followed by oral antibiotics. Neurological outcomes varied between the two patients. One patient had incomplete tetraplegia (C3 AIS C), and upon discharge required hoisting from their bed to a power chair, had an indwelling urethral catheter and required bowel care. The other patient had incomplete paraplegia (L3 AIS D), and at discharge was independent with activities of daily living and was mobile with two elbow crutches.

Discussion: We believe that the two cases presented here represent the only examples of secondarily infected atopic eczema causing PSI and resultant SCI in the published literature. As SCI is a serious and potentially life-altering complication, medical professionals treating patients with atopic eczema should be aware of this risk.

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来源期刊
Spinal Cord Series and Cases
Spinal Cord Series and Cases Medicine-Neurology (clinical)
CiteScore
2.20
自引率
8.30%
发文量
92
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