中国防痨杂志2024，Vol.46Issue(9)：1109-1114,6.DOI:10.19982/j.issn.1000-6621.20240064
误诊为脊柱结核的真菌性脊柱炎临床及影像特征分析
Clinical and imaging characterization of fungal spondylitis misdiagnosed as spinal tuberculosis
摘要
Abstract
Six fungal spondylitis cases initially misdiagnosed as spinal tuberculosis in Kunming Third People's Hospital from January 2021 to January 2024 were collected,and their clinical data and imaging data were analyzed.It was found that out of the six patients,four cases were male,with a median age of 58 years.Two cases had a history of surgery at the infection site,and one case had combined chronic liver failure.Four cases had positive pus/blood fungal culture or positive pathologic fungal test result;five cases presented pain in the infected spinal segment,and only 1 case presented fever;2 cases presented elevated peripheral blood leukocyte counts and neutrophil counts,6 cases had elevated C-reactive protein and erythrocyte sedimentation rate,and 3 cases had positive G test result.Five cases had lumbar spine lesions and 1 case had cervical spine lesions;five cases had single-segment involvement and 1 case had short-segment involvement.Only 3 cases showed bone destruction with X-rays;6 cases showed lesions in anterior and middle columns of the spine with CT examination,among them,4 cases had bone destruction centered at the intervertebral discs,and 2 cases centered at the vertebral bodies.In 5 cases,there was no osteosclerotic band around the bone destruction,and MRI showed bone destruction as isotropic T1WI high T2WI/T2WI fat-suppressed signal,while the bone around the bone destruction showed low T]WI low T2WI signal/T2WI fat-suppressed high signal,and in the other one case,there was osteosclerosis around the bone destruction,and MRI showed bone destruction as isotropic TiWI high T2WI/T2WI fat-suppressed signal,while the bone surrounding the bone destruction showed low T1WI high T2WI/T2WI fat-suppressed signal.Six cases all had no compression fracture,posterior convexity deformity,or lumbar masseter abscess on imaging.关键词
结核,脊柱/真菌病/磁共振成像/放射摄影术Key words
Tuberculosis,spinal/Mycoses/Magnetic resonance imaging/Radiography分类
医药卫生引用本文复制引用
李翔,浦英,付旭文,杞敏,魏佳璐,寸新华..误诊为脊柱结核的真菌性脊柱炎临床及影像特征分析[J].中国防痨杂志,2024,46(9):1109-1114,6.基金项目
Kunming Science and Technology Program(2024-1-NS-0032) （2024-1-NS-0032）
Scientific Research Fund Project of Yunnan Provincial Education Department(2024J0882) 昆明市科技计划项目(2024-1-NS-0032) （2024J0882）
云南省教育厅科学研究基金项目(2024J0882) （2024J0882）
