Infective Spondylodiscitis of Unknown Origin in a Patient with Chronic Kidney Disease – Case report

作者：Jenil R Patel, Maitreya Patil, Vishnu Nair, Vishal G. Kundnani, Sunil Shamjibhai Chodavadiya, Jugal Ashra · 发表于：Journal of Orthopaedic Case Reports · 年份：2024 · DOI：10.13107/jocr.2024.v14.i07.4610 · 研究领域：Infectious Diseases and Tuberculosis、Spondyloarthritis Studies and Treatments、Orthopedic Infections and Treatments

Introduction: Infective spondylodiscitis, resulting from bacterial or fungal infections in intervertebral discs and adjacent vertebral bodies, poses diagnostic dilemmas due to its rare occurrence and subtle symptomatology. This report underscores the importance of a multidisciplinary approach in navigating the complexities of infective spondylodiscitis, particularly in patients with concomitant chronic kidney disease (CKD). Case Report: A 53-year-old male, 5 years into renal dialysis for CKD, presented with a 3-month history of severe neck pain radiating to both arms, accompanied by tingling sensations. Neurological evaluation revealed weakness and gait imbalance. Laboratory findings indicated elevated serum creatinine, erythrocyte sedimentation rate, and C-reactive protein. Imaging confirmed vertebral destruction, necessitating a staged treatment plan involving surgical intervention, corpectomy, mesh placement, and fusion. Intraoperative cultures yielded negative results, prompting continued broad-spectrum antibiotic therapy intravenously for 2 weeks, followed by an additional 4 weeks orally. Discussion: The case discussion explores common risk factors for infective spondylodiscitis, emphasizing the need for a comprehensive diagnostic approach in patients with immunocompromised conditions, such as CKD. Despite negative cultures, the patient's favorable clinical response and neurological recovery underscore the intricate nature of infectious processes, especially in individua...