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Pyogenic arthritis of a lumbar facet joint, a rare cause of retroperitoneal abscess: a case report

INTRODUCTION: Pyogenic arthritis in the spinal facet joint is rare, although the wide availability of magnetic resonance imaging (MRI) has increased the detection rate. Pyogenic arthritis of a lumbar facet joint is often combined with abscesses in the paraspinal muscles and epidural space. However,...

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Autores principales: Kimura, Hiroaki, Fujibayashi, Shunsuke, Otsuki, Bungo, Matsuda, Shuichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society for Spine Surgery and Related Research 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698504/
https://www.ncbi.nlm.nih.gov/pubmed/31440663
http://dx.doi.org/10.22603/ssrr.2017-0043
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author Kimura, Hiroaki
Fujibayashi, Shunsuke
Otsuki, Bungo
Matsuda, Shuichi
author_facet Kimura, Hiroaki
Fujibayashi, Shunsuke
Otsuki, Bungo
Matsuda, Shuichi
author_sort Kimura, Hiroaki
collection PubMed
description INTRODUCTION: Pyogenic arthritis in the spinal facet joint is rare, although the wide availability of magnetic resonance imaging (MRI) has increased the detection rate. Pyogenic arthritis of a lumbar facet joint is often combined with abscesses in the paraspinal muscles and epidural space. However, there is no report of pyogenic arthritis of a lumbar facet joint causing a retroperitoneal abscess. We report on a patient with pyogenic lumbar facet arthritis, which caused a huge retroperitoneal abscess. CASE REPORT: The patient was a 67-year-old woman with a 3-week history of fever and pain in her lower back, left lower abdomen, and left thigh. Blood tests revealed high levels of inflammatory markers. Computed tomography (CT) showed a huge retroperitoneal abscess, and MRI of the lumbosacral spine showed an abscess at the left L5/S facet joint, that had invaded into the paraspinal muscles, epidural space, and retroperitoneal space. We diagnosed pyogenic arthritis of a lumbar facet joint combined with abscesses in the paraspinal muscles, epidural space, and retroperitoneal space. CT-guided percutaneous drainage of the retroperitoneal abscess was performed, and the patient was treated with antibiotics. The bacterial strain cultured was Streptococcus pneumoniae. The patient recovered after 10 weeks of antibiotic treatment combined with additional CT-guided percutaneous drainage. CONCLUSIONS: Pyogenic arthritis of a lumbar facet joint can cause a retroperitoneal abscess through the vertebral foramen as well as the more common abscesses in the paravertebral muscles and epidural space, and the finding of MRI is characteristic. The clinician should suspect of pyogenic arthritis of a lumbar facet joint in a patient presenting with retroperitoneal abscesses that are not secondary to diseases of kidney or gastrointestinal tract.
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spelling pubmed-66985042019-08-22 Pyogenic arthritis of a lumbar facet joint, a rare cause of retroperitoneal abscess: a case report Kimura, Hiroaki Fujibayashi, Shunsuke Otsuki, Bungo Matsuda, Shuichi Spine Surg Relat Res Case Report INTRODUCTION: Pyogenic arthritis in the spinal facet joint is rare, although the wide availability of magnetic resonance imaging (MRI) has increased the detection rate. Pyogenic arthritis of a lumbar facet joint is often combined with abscesses in the paraspinal muscles and epidural space. However, there is no report of pyogenic arthritis of a lumbar facet joint causing a retroperitoneal abscess. We report on a patient with pyogenic lumbar facet arthritis, which caused a huge retroperitoneal abscess. CASE REPORT: The patient was a 67-year-old woman with a 3-week history of fever and pain in her lower back, left lower abdomen, and left thigh. Blood tests revealed high levels of inflammatory markers. Computed tomography (CT) showed a huge retroperitoneal abscess, and MRI of the lumbosacral spine showed an abscess at the left L5/S facet joint, that had invaded into the paraspinal muscles, epidural space, and retroperitoneal space. We diagnosed pyogenic arthritis of a lumbar facet joint combined with abscesses in the paraspinal muscles, epidural space, and retroperitoneal space. CT-guided percutaneous drainage of the retroperitoneal abscess was performed, and the patient was treated with antibiotics. The bacterial strain cultured was Streptococcus pneumoniae. The patient recovered after 10 weeks of antibiotic treatment combined with additional CT-guided percutaneous drainage. CONCLUSIONS: Pyogenic arthritis of a lumbar facet joint can cause a retroperitoneal abscess through the vertebral foramen as well as the more common abscesses in the paravertebral muscles and epidural space, and the finding of MRI is characteristic. The clinician should suspect of pyogenic arthritis of a lumbar facet joint in a patient presenting with retroperitoneal abscesses that are not secondary to diseases of kidney or gastrointestinal tract. The Japanese Society for Spine Surgery and Related Research 2018-02-28 /pmc/articles/PMC6698504/ /pubmed/31440663 http://dx.doi.org/10.22603/ssrr.2017-0043 Text en Copyright © 2018 by The Japanese Society for Spine Surgery and Related Research https://creativecommons.org/licenses/by-nc-nd/4.0/ Spine Surgery and Related Research is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Kimura, Hiroaki
Fujibayashi, Shunsuke
Otsuki, Bungo
Matsuda, Shuichi
Pyogenic arthritis of a lumbar facet joint, a rare cause of retroperitoneal abscess: a case report
title Pyogenic arthritis of a lumbar facet joint, a rare cause of retroperitoneal abscess: a case report
title_full Pyogenic arthritis of a lumbar facet joint, a rare cause of retroperitoneal abscess: a case report
title_fullStr Pyogenic arthritis of a lumbar facet joint, a rare cause of retroperitoneal abscess: a case report
title_full_unstemmed Pyogenic arthritis of a lumbar facet joint, a rare cause of retroperitoneal abscess: a case report
title_short Pyogenic arthritis of a lumbar facet joint, a rare cause of retroperitoneal abscess: a case report
title_sort pyogenic arthritis of a lumbar facet joint, a rare cause of retroperitoneal abscess: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698504/
https://www.ncbi.nlm.nih.gov/pubmed/31440663
http://dx.doi.org/10.22603/ssrr.2017-0043
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