- 期刊
L-Spine Spondylitis and Epidural Abscess Caused by Group C1 Salmonella Leading to Severe Neurological Complication in a Patient with Systemic Lupus Erythematosus
红斑性狼瘡病人因Gruop C1沙門桿菌引起的腰椎脊炎和硬膜上膿瘍導致嚴重神經學併發症
摘要
紅斑性狼瘡炎(Systemic lupus erythematosus, SLE)、淋巴瘤或免疫抑制的病人常會遇到沙門桿菌的感染，這些病人可能性發生敗血病，敗血性關節炎或皮下膿瘍和罕見的侵入性神經系統病變。本篇報告一個G6PD缺乏症的病人，使用皮質類固醇(corticosteroid)治療SLE被沙門桿菌Group C1感染併發腰椎脊椎炎和硬膜上的膿瘍，這個案例說明了沙門桿菌在免疫功能不全的病患可以發生嚴重的疾病，沙門桿菌脊椎炎和硬膜上的膿瘍引起的嚴重併發症會導致兩腿無力和麻痹，當這些嚴重的併發症發生時，外科手術是必要的，而且適當的抗生素治療非常重要。
並列摘要
Salmonella infection is encountered frequently in the immunosuppressed patients and in those with diseases such as systemic lupus erythematosus(SLE) and lymphoma. They can present with septicemia, septic arthritis or subcutaneous abscess, which seldom invades the nervous system. We present a 58-year-old male patient with underlying diseases of G6PD deficiency, and SLE under treatment with corticosteroid who had L-spine spondylitis and epidural abscess caused by Salmonella group C1. Inadequate treatment of Salmonella infection previously may play an important role. The severe complications of Salmonella spondylitis and epidural abscess led to bilateral leg weakness and numbmess. After 2 weeks of intravenous ceftriaxone, laminectomy of the L2-3 and prolonged oral ciprofloxacin therapy, the neurological deficit recovered 3 months later. The case reminds us that spinal infection caused by Salmonella should be considered if the immunosuppressed patient is febrile and back pain. Surgical intervention is necessary when this severe complication occurs and adequate antibiotics are also important.
延伸閱讀
- 陳英州、鄭添財、吳建輝、賴漢明（1995）。紅斑性狼瘡合併橫貫性脊髓炎及水腦症－病例報告。Formosan Journal of Rheumatology，12(1&2)，21-29。https://doi.org/10.6313/FJR.199505_12(1_2).0003
- 曾惠瑜、程琡敏、陳若佟、官大紳、王崇任（2001）。全身性紅斑性狼瘡併發大範圍脊髓侵犯之急性橫斷性脊髓炎：病例報告。中華民國復健醫學會雜誌，29(3)，153-158。https://www.airitilibrary.com/Article/Detail?DocID=10253009-200109-29-3-153-158-a
- Wang, W. Y., Huang, S. Y., Hsu, C. J., Huang, Y. C., & Wang, P. C. (2005). 紅斑性狼瘡成人併發肺炎雙球菌敗血症引起的腦膜炎續發細菌性迷路炎－病例報告. 輔仁醫學期刊, 3(1), 9-15. https://www.airitilibrary.com/Article/Detail?DocID=18102093-200506-3-1-9-15-a
- 蔡明勳、陳清煌（1986）。紅斑性狼瘡引致增殖性網膜症－病例報告。中華民國眼科醫學會雜誌，25(1)，327-330。https://doi.org/10.30048/ACTASOS.198605.0060
- 楊令瑀、趙婷、林清淵、黃碧桃（1992）。紅斑性狼瘡合併Graves氏症。Acta Paediatrica Sinica，33(s_1)，12-14。https://www.airitilibrary.com/Article/Detail?DocID=00016578-199201-33-s_1-12-14-a