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Koexistente septische Arthritis und Spondylodiszitis als wichtige Differenzialdiagnose bei immunsupprimierten Patienten

Septic arthritis and spondylodiscitis, especially in immunocompromised patients, constitute a major differential diagnosis of joint or back pain. This results in the invasion of a joint or spinal disc and its adjacent vertebral body by a pathogen. In most cases this is manifested as unspecific sympt...

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Detalles Bibliográficos
Autores principales: Pfahler, S., Pflugmacher, R., Karakostas, P., Dabir, D., Schäfer, V. S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Medizin 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929961/
https://www.ncbi.nlm.nih.gov/pubmed/33336292
http://dx.doi.org/10.1007/s00393-020-00943-8
Descripción
Sumario:Septic arthritis and spondylodiscitis, especially in immunocompromised patients, constitute a major differential diagnosis of joint or back pain. This results in the invasion of a joint or spinal disc and its adjacent vertebral body by a pathogen. In most cases this is manifested as unspecific symptoms, such as local joint or back pain, fever and malaise. If this is clinically suspected the bacterial infection of the joint can be confirmed by joint puncture and blood culture. For the diagnosis of spondylodiscitis magnetic resonance imaging should be used for visualization. In addition to adequate pain treatment and empirical antibiotic treatment, an arthroscopic removal of infected intra-articular tissue and debris is imperative. When complications caused by spondylodiscitis arise a surgical removal and stabilization should be performed. The following case report presents the findings of septic polyarthritis and spondylodiscitis in an immunocompromised patient with an HIV infection and provides insights into the occurrence of complications due to the delay of adequate treatment.