The Journal of Bone and Joint Surgery (American). 2006;88:2275-2278.
doi:10.2106/JBJS.E.01121
© 2006 The Journal of Bone and Joint Surgery, Inc.
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Tuberculous Spondylitis and Salmonella Mycotic Aneurysm in an Immunocompromised Patient

A Case Report

Shih-Hao Chen, MD1, To Wong, MD1, Fang-Ying Kuo, MD1 and Chen-Hsiang Lee, MD1

1 Departments of Orthopaedic Surgery (S.-H.C. and T.W.) and Pathology (F.-Y.K.) and Division of Infectious Diseases (C.-H.L.), Chang Gung Memorial Hospital, No.123, Ta Pei Road 833, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan. E-mail address for C.-H. Lee: lee900@adm.cgmh.org.tw

Investigation performed at the Departments of Orthopaedic Surgery and Pathology and the Division of Infectious Diseases, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University of Medicine, Kaohsiung, Taiwan

The first 150 words of the full text of this article appear below.


   Introduction
 
Despite the proximity of the vertebral bodies and discs to the vascular structures of the retroperitoneum, the association of spinal osteomyelitis and aortic infection is a rare1, easily overlooked, but potentially lethal condition that requires prompt diagnosis and aggressive surgical therapy. The pathogens responsible for concurrent vertebral and aortic lesions include Salmonella species as well as other gram-negative bacilli, mycobacteria, gram-positive cocci, and fungi1-3. A delay in the start of appropriate antimicrobial therapy for infections involving these anatomic sites could result in bone and joint destruction and possibly death. We report the case of an elderly immunocompromised patient who had a mycotic aneurysm caused by Salmonella species. After aneurysmectomy, he experienced persistent back pain and progressive loss of lower-extremity neurological function. Further work up disclosed tuberculous lumbar spondylitis and an epidural abscess in the vicinity of the resected aneurysm. The case of this patient emphasizes the possibility of . . . [Full Text of this Article]


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