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Empyema in spinal canal in thoracic region, abscesses in paravertebral space, spondylitis: in clinical course of zoonosis Erysipelothrix rhusiopathiae.

Andrychowski J, Jasielski P, Netczuk T, Czernicki Z - Eur Spine J (2012)

Bottom Line: After therapy neurological status was improved.Various complications of the disease, such as endocarditis and heart valves disturbances, are well known and are the most severe complications of the generalised infection.Proper targeted and long-term antibiotic therapy is crucial.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Mossakowski Medical Research Centre, Polish Academy of Sciences, Bielanski Hospital, Ceglowska Str 80, 01-809, Warsaw, Poland. j.andrychowski@wp.pl

ABSTRACT

Objectives: Erysipelas is an animal disease caused by Gram-positive bacteria Erysipelothrix rhusiopathiae. Among the domestic animals, domestic pig (Sus scrofa f. domestica) suffers most frequently from the disease in human environment. This is a typical animal-borne disease observed mainly in occupational groups employed in agriculture, farming (of animals and birds), fishing and manufacturing industry.

Methods: We are presenting the clinical course of infection (E. rhusiopathiae) and discuss clinical forms. E. rhusiopathiae in humans may have the following clinical course: mild form of skin infection diagnosed as local erythema (erysipeloid), disseminated form of skin infection and the most serious form of infection of systemic course (endocarditis and sepsis). Mild skin infection and local erythema are the most common forms. Very rare case of animal-borne infection course has been presented in which after initial phase the disease was generalised to the abscesses formation in paravertebral space, spondylitis and empyema formation in spinal canal. In the presented clinical case, the patient was suffering from diabetes. It was probably an additional risk factor of the disease generalisation. Patient underwent drainage of empyema in spinal canal, after which his neurological status gradually improved. Antibiotic therapy was implemented and continued for 8 weeks. Such course of erysipelas was not previously described in the literature.

Results: After therapy neurological status was improved. In follow MRI control exam empyema and spondylitis was successfully eliminated.

Conclusions: Various complications of the disease, such as endocarditis and heart valves disturbances, are well known and are the most severe complications of the generalised infection. Proper targeted and long-term antibiotic therapy is crucial.

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Related in: MedlinePlus

MRI examination before operation. Inflammatory process in the vertebrae and disc. Disc space narrowing and abscess in spinal canal
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Fig1: MRI examination before operation. Inflammatory process in the vertebrae and disc. Disc space narrowing and abscess in spinal canal

Mentions: CT scans revealed destruction of the thoracic vertebras, infiltration changes in paravertebral soft tissues and pathological mass in the spinal canal. Initial diagnosis included infiltrative malignant tumour of the vertebral column. Consulting neurosurgeon recommended MRI examination. Examination revealed the presence of changes suggesting inflammatory process of the thoracic spine Th5–Th6, inflammatory changes within intervertebral discs and vertebral bodies and changes inside the spinal canal suggesting fluid mass empyema compressing the spinal cord (Figs. 1, 2).Fig. 1


Empyema in spinal canal in thoracic region, abscesses in paravertebral space, spondylitis: in clinical course of zoonosis Erysipelothrix rhusiopathiae.

Andrychowski J, Jasielski P, Netczuk T, Czernicki Z - Eur Spine J (2012)

MRI examination before operation. Inflammatory process in the vertebrae and disc. Disc space narrowing and abscess in spinal canal
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3369048&req=5

Fig1: MRI examination before operation. Inflammatory process in the vertebrae and disc. Disc space narrowing and abscess in spinal canal
Mentions: CT scans revealed destruction of the thoracic vertebras, infiltration changes in paravertebral soft tissues and pathological mass in the spinal canal. Initial diagnosis included infiltrative malignant tumour of the vertebral column. Consulting neurosurgeon recommended MRI examination. Examination revealed the presence of changes suggesting inflammatory process of the thoracic spine Th5–Th6, inflammatory changes within intervertebral discs and vertebral bodies and changes inside the spinal canal suggesting fluid mass empyema compressing the spinal cord (Figs. 1, 2).Fig. 1

Bottom Line: After therapy neurological status was improved.Various complications of the disease, such as endocarditis and heart valves disturbances, are well known and are the most severe complications of the generalised infection.Proper targeted and long-term antibiotic therapy is crucial.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Mossakowski Medical Research Centre, Polish Academy of Sciences, Bielanski Hospital, Ceglowska Str 80, 01-809, Warsaw, Poland. j.andrychowski@wp.pl

ABSTRACT

Objectives: Erysipelas is an animal disease caused by Gram-positive bacteria Erysipelothrix rhusiopathiae. Among the domestic animals, domestic pig (Sus scrofa f. domestica) suffers most frequently from the disease in human environment. This is a typical animal-borne disease observed mainly in occupational groups employed in agriculture, farming (of animals and birds), fishing and manufacturing industry.

Methods: We are presenting the clinical course of infection (E. rhusiopathiae) and discuss clinical forms. E. rhusiopathiae in humans may have the following clinical course: mild form of skin infection diagnosed as local erythema (erysipeloid), disseminated form of skin infection and the most serious form of infection of systemic course (endocarditis and sepsis). Mild skin infection and local erythema are the most common forms. Very rare case of animal-borne infection course has been presented in which after initial phase the disease was generalised to the abscesses formation in paravertebral space, spondylitis and empyema formation in spinal canal. In the presented clinical case, the patient was suffering from diabetes. It was probably an additional risk factor of the disease generalisation. Patient underwent drainage of empyema in spinal canal, after which his neurological status gradually improved. Antibiotic therapy was implemented and continued for 8 weeks. Such course of erysipelas was not previously described in the literature.

Results: After therapy neurological status was improved. In follow MRI control exam empyema and spondylitis was successfully eliminated.

Conclusions: Various complications of the disease, such as endocarditis and heart valves disturbances, are well known and are the most severe complications of the generalised infection. Proper targeted and long-term antibiotic therapy is crucial.

Show MeSH
Related in: MedlinePlus