• Title/Summary/Keyword: 척추 골수염

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Late-Onset Candida Vertebral Osteomyelitis in Two Young Patients Who Underwent Heart Transplant Surgery (심장 이식술을 받은 젊은 환자에서 발생한 2예의 지연성 칸디다 척추 골수염)

  • Kang, Min Seok;Son, In Seok;Kim, Tae Hoon;Lee, Suk Ha
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.72-77
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    • 2019
  • Candida vertebral osteomyelitis (CVO) is a rare disease that is a complication of intravenous drug use, but recently it has been recognized as mostly an opportunistic infection. Because CVO appears to mimic pyogenic spondylodiscitis in terms of the clinical and radiologic presentations, it is often neglected in a usual clinical setting. The clinical, radiological, and biological characteristics of CVO are often used to make a differential diagnosis with vertebral osteomyelitis from other etiologies. Once an initial proper diagnosis was performed, the treatment relies on the prompt initiation of appropriate pharmacotherapy and serial monitoring of the clinical progress. This paper report late-onset CVO in two young patients who underwent a heart transplant surgery and had postoperative systemic candidiasis. These two cases are a good reminder of the potential of CVO in immunosuppressive patients treated with anti-fungal agents. This paper presents these two cases with a review of the relevant literature.

A Case of Neonatal Osteomyelitis of Thoracic Vertebrae due to MRSA (흉추에 생긴 MRSA에 의한 신생아 골수염 1례)

  • Park, Eun Sook;Shin, Seon Hee;Kim, Sung Goo;Yoon, Hae Sun
    • Pediatric Infection and Vaccine
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    • v.9 no.2
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    • pp.236-240
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    • 2002
  • Vertebral osteomyelitis represents only 1% to 2% of osteomyelitis and may pose a diagnostic conundrum, with disastrous consequences if diagnosis and therapy are delayed. We report a neonate with the unique association of vertebral osteomyelitis and MRSA infection. A 1-month-old boy was admitted to the hospital for evaluation of high fever and decreased oral intake. He was born at 34 wks, and his birth weight was 1.6 kg. We founded MRSA on his blood culture. Magnetic resonance imaging study showed findings of T7-T8 vertebral osteomyelitis. With 8 weeks of intravenous vancomycin treatment, the patient improved clinically and radiologically.

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The Usefulness of Diffusion-weighted MR Imaging for Differentiation between Degenerative Spines and Infectious Spondylitis (퇴행성 척추와 감염성 척추염의 감별에 있어서 확산강조영상의 유용성)

  • 박원규;변우목;최준혁
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.2
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    • pp.152-157
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    • 2002
  • Purpose : The differential diagnosis between Modic type I degenerative spine and infectious spondylitis sometimes is difficult, because the affected bone marrows in both disease show similar signal intensity on conventional MR imaging. We evaluate the usefulness of diffusion-wighted MR imaging for differential diagnosis between Modic type I degenerative spine and infectious spondylitis. Materials and methods : The spin-echo and diffusion-weighted MR images of eight patients with Modic type I degenerative spines and 14 patients with infectious spondylitis diagnosed by clinical findings or CT-guided biopsies we re analyzed. The diffusion-weighted imaging sequence was based on reversed fast imaging with steady-state precession (PSIF). Signal intensity changes of the vertebral bone marrow on conventional spin-echo and diffusion-weighted MR imaging were compared between degenerative spine and infectious spondylitis. Results : On T1-weighte d images, the affeted bone marrow in both disease showed hypointense signals. On T 2-weighted images, all of type I degenerative spine and 11 of infectious spondylitis showed hyperintensity, and three of infectious spondylitis showed heterogeneo us mixed signal intensity. On diffusion-weighted MR images, all of type I degenerative spine were hypointense with peripheral high signal intensity to normal vertebral body, but infectious spondylitis was hyperintense (n = 11) and hypointense (n=3). Conclusion : Diffusion-weighted MR imaging is useful to differentiate Modic type I degenerative spine from infectious spondylitis. On diffusion-weighted images, the high singal intensity of bone marrow suggests infectious spondylitis, whereas the low signal intensity of bone marrow with peripheral focal high signal intensity suggests type I degenerative spine.

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Pathophysiology and MRI Findings of Infectious Spondylitis and the Differential Diagnosis (감염성 척추염과 감별질환의 병태생리와 MRI 소견)

  • Sunjin Ryu;Yeo Ju Kim;Seunghun Lee;Jeongah Ryu;Sunghoon Park;Jung Ui Hong
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1413-1440
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    • 2021
  • On MRI, abnormal signals of the intervertebral disc, destruction of the upper and lower vertebral body endplate around the disc, and bone marrow edema around the endplate are considered typical findings of infectious spondylitis. These findings can also appear in various non-infectious spinal diseases, such as degenerative changes, acute Schmorl's node, spondyloarthropathy, synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO), chronic recurrent multifocal osteomyelitis, and calcium pyrophosphate dihydrate crystal deposition disease. The imaging findings of infectious spondylitis that can be differentiated from these non-infectious spinal diseases on MRI are high signal intensity and abscess of the disc space, an abscess in the paraspinal soft tissue, and the loss of the linear low signal intensity on T1-weighted images of the bony endplate. However, these differentiation points do not always apply since there are many similarities in the imaging findings of infectious and non-infectious diseases. Therefore, for an accurate diagnosis, it is important to know the imaging characteristics related to the pathophysiology of not only infectious spondylitis but also non-infectious spinal diseases, which requires differentiation from infection.

Lumbar Vertebral Osteomyelitis in a Dog (개에서 발생한 척추골 골수염 증례)

  • Lee, Min-Su;Jung, Mi-Ae;Jeong, Soon-Wuk;Park, Hee-Myung;Kim, Hwi-Yul;Eom, Ki-Dong
    • Journal of Veterinary Clinics
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    • v.25 no.1
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    • pp.64-66
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    • 2008
  • A castrated male, 9-year-old Yorkshire terrier was presented with a depression and bilateral hind limbs lameness. On physical examinations, upper motor neuron signs and stiffness of the hind limbs, back pain and progressive paresis were identified. Marked periosteal new bone formations and lysis include the first lumbar vertebra to the sacrum, bilateral iliums acetabulums and bilateral femoral heads were observed in survey radiographs. After death with septicemia suspected, renal infarction and the 5th vertebral osteomyelitis include pelvic periostitis were diagnosed in histological examination.

Clinical Significance of MRI Findings During Medical Treatment for Tuberculous Spondylitis (척추염 환자의 약물치료기간 중 추적 검사한 MRI소견 변화의 임상적 중요성)

  • Kim, Dae-Jung;Chung, Tae-Sub;Suh, Sang-Hyun;Kim, Keun-Su;Cho, Yong-Eun;Yoon, Young-Sul;Kim, Sam-Soo
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.2
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    • pp.146-151
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    • 2009
  • Purpose : To evaluate magnetic resonance (MR) imaging features of non-surgically treated tuberculous spondylitis and to evaluate the relationships between these features and clinical outcomes. Materials and Methods : Data from ten patients (male:female=6:4, mean age=45 years) with clinically proven tuberculous spondylitis who were treated nonsurgically over three months were analyzed retrospectively from 2000 to 2007. MRI was performed at least three times for each patient, at baseline, every three or six months, and at the end of treatment. All images were analyzed by two radiologists. Results : The mean follow-up period for the MR examination was 10.1 months (range, 4-17 months). Six patients had clinically complete resolution of tuberculous spondylitis with medication treatment only. Four patients were treated with surgical management alongside medication. All ten patients were divided into two groups by clinical outcome; six patients with complete treatment and four patients with incomplete treatment. In the complete treatment group, follow-up MR findings showed a loss of subligamentous spread of abscesses, decreased size of abscesses, no interval changes in vertebral body heights, and fatty changes in spinal lesions. MR findings in the incomplete treatment group showed bone marrow edema extension to adjacent vertebra, extension of the abscesses, and decreased height of the vertebral bodies. Conclusion : During the nonsurgical management of tuberculous spondylitis, MR imaging may play a role in predicting patient response to antituberculous drug treatment.

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Detoxification of PSP and relationship between PSP toxicity and Protogonyaulax sp. (마비성패류독의 제독방법 및 패류독성과 원인플랑크톤과의 관계에 관한 연구)

  • CHANG Dong-Suck;SHIN Il-Shik;KIM Ji-Hoe;PYUN Jae-hueung;CHOE Wi-Kung
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.22 no.4
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    • pp.177-188
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    • 1989
  • The purpose of this study was to investigate the detoxifying effect on PSP-infested sea mussel, Mytilus edulis, by heating treatment and correlation between the PSP toxicity and the environmental conditions of shellfish culture area such as temperature, pH, salinity, density of Protogonyaulax sp. and concentration of inorganic nutrients such as $NH_4-N,\;NO_3-N,\;NO_2-N\;and\;PO_4-P$. This experiment was carried out at $Suj\u{o}ng$ in Masan, Yangdo in Jindong, $Hach\u{o}ng\;in\;K\u{o}jedo\;and\;Gamch\u{o}n$ bay in Pusan from February to June in $1987\~1989$. It was observed that the detection ratio and toxicity of PSP in sea mussel were different by the year even same collected area. The PSP was often detected when the temperature of sea water about $8.0\~14.0^{\circ}C$. Sometimes the PSP fox of sea mussel was closely related to density of Protogonyaulax sp. at $Gamch\u{o}n$ bay in Pusan from March to April in 1989, but no relationship was observed except above duration during the study period. The concentration of inorganic nutrients effects on the growth of Protogonyaulax sp., then effects of $NO_3-N$ was the strongest among them. When the PSP-infested sea mussel homogenate was heated at various temperature, the PSP toxicity was not changed significantly at below $70^{\circ}C$ for 60 min. but it was proper-tionaly decreased as the heating temperature was increased. For example, when the sea mussel homogenate was heated at $100^{\circ}C,\;121^{\circ}C$ for 10 min., the toxicity was decreased about $67\%\;and\;90\%$, respectively. On the other hand, when shellstock sea mussel contained PSP of $150{\mu}g/100g$ was boiled at $100^{\circ}C$ for 30 min. with tap water, the toxicity was not detected by mouse assay, but that of PSP of $5400{\mu}g/100g$ was reduced to $57{\mu}g/100g$ even after boiling for 120 min.

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