|
Abstract To explore the clinical features and imaging features of pyogenic vertebral osteomyelitis (PVO) caused by staphylococcus.Retrospectively analyzed the clinical characteristics, laboratory examinations and imaging examinations of 20 cases of PVO caused by staphylococcus admitted to the Department of Infection, the Sixth Hospital of Shanghai Jiaotong University from January 2010 to December 2019. The results showed: 20 patients were mainly infected with Staphylococcus aureus, 12 patients developed paravertebral abscess, and 3 patients had a clear history of spinal injury before infection. About 85% occurred in the lumbar spine, 13 patients (65%) had fever, about 50% of patients had elevated white blood cell counts, and C-reactive protein, erythrocyte sedimentation rate, and ferritin in all patients. CT plain scan showed that the infected vertebral body showed bone destruction, accompanied by swelling of surrounding soft tissues. Enhanced CT showed multiple cysts with low-density shadow enhancement and marginal ring-shaped enhancement shadows were seen, but no obvious enhancement in the center. MRI lesion vertebral body and intervertebral disc destruction area showed abnormal signal focus, which showed T1W low signal and T2W lipid pressure high signal. ECT showed uneven radioactive uptake of the diseased vertebral body. Pathological examination revealed inflammatory lesions. The pathogenic bacteria in 4 patients (20%) were MRSA. Over 80% of infected bacteria were not sensitive to penicillin. Twelve patients with paravertebral abscess were recovered by CT-guided drainage combined with sensitive antibiotic treatment. Conclusion: Staphylococcus aureus is the main pathogenic bacteria caused by staphylococcus pyogenic vertebral osteomyelitis. It is generally resistant to penicillin. Imaging examination is of great value in the diagnosis of disease. C-reactive protein, erythrocyte sedimentation rate and MRI can reflect the improvement of the disease. In the recovery period of the disease, laboratory results return to normal earlier than imaging.
|
|
Received: 23 July 2020
Published: 01 January 2022
|
|
|
|
|
|
