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Paraplegia secondary to disseminated mucormycosis: case report and literature review

BACKGROUND: We report a case of spine infection with mucormycosis that manifested signs of paraplegia in a patient suffering from disseminated mucormycosis. Timely and effective surgery was performed. A review of the literature is included. CASE PRESENTATION: A patient with diabetic ketoacidosis com...

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Autores principales: Shi, Xiangjun, Qi, Lei, Du, Boran, Yao, Xingchen, Du, Xinru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9036692/
https://www.ncbi.nlm.nih.gov/pubmed/35468738
http://dx.doi.org/10.1186/s12879-022-07373-8
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author Shi, Xiangjun
Qi, Lei
Du, Boran
Yao, Xingchen
Du, Xinru
author_facet Shi, Xiangjun
Qi, Lei
Du, Boran
Yao, Xingchen
Du, Xinru
author_sort Shi, Xiangjun
collection PubMed
description BACKGROUND: We report a case of spine infection with mucormycosis that manifested signs of paraplegia in a patient suffering from disseminated mucormycosis. Timely and effective surgery was performed. A review of the literature is included. CASE PRESENTATION: A patient with diabetic ketoacidosis complained of back pain and fatigue for one month, and his right lower extremity activity had been limited for 10 days. T4–T6 vertebral and paravertebral soft tissue-involved infections were identified by MRI, which were derived from right lung pneumonia. He underwent abscess debridement, spinal canal decompression, pedicle screw fixation and amphotericin B liposome injection. Histopathological examination revealed broad aseptate hyphae suggestive of invasive mucormycosis. There was improvement in neurological function after surgical and medical treatment. Three months after the surgery, the patient died of uncontrollable massive bleeding of the urinary system. Mucormycosis is characterized by rapid development and a high mortality rate. This case shows the significance of a multidisciplinary team in the diagnosis and treatment of patients with mucormycosis. In addition, orthopedic surgeons should design appropriate surgery plans for spine-involved mucormycosis patients. CONCLUSION: This case present a patient with paraplegia caused by the spread of pulmonary mucormycosis to the vertebral and paravertebral soft tissue of levels T4–T6. After medical treatment, surgical debridement and internal fixation, the patient recovered well but later patient died of possible disease dissemination to the renal or urinary tract which resulted in massive haemorrhage.
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spelling pubmed-90366922022-04-26 Paraplegia secondary to disseminated mucormycosis: case report and literature review Shi, Xiangjun Qi, Lei Du, Boran Yao, Xingchen Du, Xinru BMC Infect Dis Case Report BACKGROUND: We report a case of spine infection with mucormycosis that manifested signs of paraplegia in a patient suffering from disseminated mucormycosis. Timely and effective surgery was performed. A review of the literature is included. CASE PRESENTATION: A patient with diabetic ketoacidosis complained of back pain and fatigue for one month, and his right lower extremity activity had been limited for 10 days. T4–T6 vertebral and paravertebral soft tissue-involved infections were identified by MRI, which were derived from right lung pneumonia. He underwent abscess debridement, spinal canal decompression, pedicle screw fixation and amphotericin B liposome injection. Histopathological examination revealed broad aseptate hyphae suggestive of invasive mucormycosis. There was improvement in neurological function after surgical and medical treatment. Three months after the surgery, the patient died of uncontrollable massive bleeding of the urinary system. Mucormycosis is characterized by rapid development and a high mortality rate. This case shows the significance of a multidisciplinary team in the diagnosis and treatment of patients with mucormycosis. In addition, orthopedic surgeons should design appropriate surgery plans for spine-involved mucormycosis patients. CONCLUSION: This case present a patient with paraplegia caused by the spread of pulmonary mucormycosis to the vertebral and paravertebral soft tissue of levels T4–T6. After medical treatment, surgical debridement and internal fixation, the patient recovered well but later patient died of possible disease dissemination to the renal or urinary tract which resulted in massive haemorrhage. BioMed Central 2022-04-25 /pmc/articles/PMC9036692/ /pubmed/35468738 http://dx.doi.org/10.1186/s12879-022-07373-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visithttp://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Shi, Xiangjun
Qi, Lei
Du, Boran
Yao, Xingchen
Du, Xinru
Paraplegia secondary to disseminated mucormycosis: case report and literature review
title Paraplegia secondary to disseminated mucormycosis: case report and literature review
title_full Paraplegia secondary to disseminated mucormycosis: case report and literature review
title_fullStr Paraplegia secondary to disseminated mucormycosis: case report and literature review
title_full_unstemmed Paraplegia secondary to disseminated mucormycosis: case report and literature review
title_short Paraplegia secondary to disseminated mucormycosis: case report and literature review
title_sort paraplegia secondary to disseminated mucormycosis: case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9036692/
https://www.ncbi.nlm.nih.gov/pubmed/35468738
http://dx.doi.org/10.1186/s12879-022-07373-8
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