临床误诊误治Issue(3)：40-43,4.DOI:10.3969/j.issn.1002-3429.2015.03.015
腰椎金属支架固定术后移植物感染一例报告并文献复习
Implant Infection after Lumbar Metal Stents Fixation：A Case Report and Literature Review
摘要
Abstract
Objective To explore clinical characteristics, key points of diagnosis and treatment of implant infections. Methods Clinical data of one patient with implant infection were retrospectively analyzed and related literature was also re-viewed. Results The patient was admitted for abdominal pain, lumbago and fever and was examined with ultrasonography, CT and laboratory testing in other institutions, for intestinal obstruction. The patient received treatment of gastrointestinal de-compression and antibiotics, but his symptoms had no mitigation. After being admitted to our emergency department, the pa-tient was examined with pathogen and MRI. Combining with the history of lumbar metal stents fixation, clinicians revised the diagnosis to psoas abscess and hematoma, and spine implant infection was suspected. The patient received treatments inclu-ding topical percutaneous puncture catheter drainage, anti-infection treatment according to the results of blood culture and drug sensitivity, intravenous fluids, abatement of fever and other symptomatic therapy, the symptoms were alleviated. The patient family insisted that the patient be sent back to a local hospital for treatment. Clinical follow up for one month revealed that de-finitive diagnosis was implant infection after lumbar metal stents fixation. After the patient underwent surgery to remove the im-plant combined with anti-infection therapy based on pathogen-detecting results, the patient recovered. Conclusion The early clinical manifestation of implant infections lacks specificity, and the disease is apt to be misdiagnosed. After eliminating other common suspected causes of infection, clinicians should consider the possibility of the disease when the patient has unex-plained symptoms of systemic infection and the medical history of implant infection. Relevant inspections should be carried in time in order to make an early diagnosis of the disease.关键词
脊柱/支架(骨科)/移植物/医院感染/误诊/结核Key words
Spine/Brace/Transplant/Hospital infection/Diagnostic error/Tuberculosis分类
医药卫生引用本文复制引用
王越越,朱海燕,郭明广,宋扬,孟庆义..腰椎金属支架固定术后移植物感染一例报告并文献复习[J].临床误诊误治,2015,(3):40-43,4.基金项目
军队医药卫生科研基金应用基础研究面上项目(CWS12J1250) （CWS12J1250）
