非典型临床表现脊柱结核合并冷脓肿1例-国际临床研究杂志-CSCIED科技核心评价数据库-手机版

非典型临床表现脊柱结核合并冷脓肿1例

A case of spinal tuberculosis with cold abscess presenting with atypical clinical manifestations

ES评分 0 浏览量：283 下载量：0

DOI	10.12208/j.ijcr.20250366
刊名	国际临床研究杂志 International Journal of Clinical Research
年，卷(期)	2025, 9(8)
作者	刘佩¹, 郑盛²,
作者单位	1 大理大学临床医学院云南大理 2 大理大学第二附属医院云南昆明
摘要	脊柱结核（spinal tuberculosis，STB）是肺或其它部位结核杆菌经血行播散到椎体骨质内引起脊柱骨髓炎症性疾病，它约占骨骼结核病例50%，脊柱结构的破坏会导致脓肿的形成，脓肿可在筋膜和神经血管平面后作为冷脓肿到达远端部位[1]。脊柱结核由于早期临床症状和影像学表现缺乏特异性，难以与不典型脊柱转移瘤、布鲁氏菌病等疾病鉴别，其漏诊、误诊率较高，若未及时治疗，会导致患者病情恶化甚至截瘫[2]。因此，本文报道1例不典型临床表现的脊柱结核合并冷脓肿患者，该患者以腹痛为主诉，无发热、盗汗等典型结核中毒症状，早期易误诊为腹腔疾病，通过探讨其临床特点、影像学表现，从而提高临床医师对脊柱结核的认识，避免漏诊、误诊的发生。
Abstract	Spinal tuberculosis (STB) is an inflammatory disease of the spinal bone marrow caused by Mycobacterium tuberculosis disseminated through the bloodstream to the vertebral bone. It accounts for approximately 50% of bone tuberculosis cases. The destruction of the spinal structure can lead to the formation of abscesses, which can spread as cold abscess along the fascia and neurovascular planes to distant sites [1]. Due to the lack of specificity in early clinical symptoms and imaging manifestations, spinal tuberculosis is difficult to distinguish from atypical spinal metastases, brucellosis, and other diseases, resulting in a high rate of missed and misdiagnosis. If not treated in time, it can lead to deterioration of the patient's condition and even paraplegia [2]. Therefore, this article reports a case of atypical clinical manifestations of spinal tuberculosis complicated with cold abscess. The patient mainly complained of abdominal pain and had no typical tuberculosis toxic symptoms such as fever and night sweats. In the early stage, it was easily misdiagnosed as abdominal cavity disease. By discussing its clinical characteristics and imaging manifestations, it aims to enhance the understanding of spinal tuberculosis among clinicians and avoid the occurrence of missed diagnosis and misdiagnosis.
关键词	结核病；脊柱结核；冷脓肿；临床特点；早期识别
KeyWord	Tuberculosis; Spinal tuberculosis; Cold abscess; Clinical characteristics; Early identification
基金项目
页码	10-17

参考文献
相关文献

[1] Kumar V, Neradi D, Sherry B, et al. Tuberculosis of the spine and drug resistance: a review article
[J]. Neurosurgical Review, 2022, 45(1): 217-229.

[2] Wang B, Gao W, Hao D. Current Study of the Detection and Treatment Targets of Spinal Tuberculosis
[J]. Current Drug Targets, 2020, 21(4): 320-327.

[3] Aung L L W, Jibon N, Rawashdeh L, et al. Spinal Tuberculosis (Pott's Disease): A Case Report and Clinical Considerations
[J]. Cureus, 2024,16(11):e73903.

[4] Shanmuganathan R, Ramachandran K, Shetty A P, et al. Active tuberculosis of spine: Current updates
[J]. North American Spine Society Journal (NASSJ), 2023, 16: 100267.

[5] Leowattana W, Leowattana P, Leowattana T. Tuberculosis of the spine
[J]. World Journal of Orthopedics, 2023, 14(5): 275-293.

[6] 王立新,袁峰,赵凤朝,等.不典型脊柱结核的临床特点分析
[J].中国矫形外科杂志,2011,19(07):605-607.

[7] 王立强,靳颖,刘树芳,等.早期和非典型脊柱结核中MRI的诊断分析
[J].河北医科大学学报,2020,41(09):1047-1049+1069.

[8] Abid W, Ladeb M F, Chidambaranathan N, et al. Imaging of musculoskeletal tuberculosis
[J]. Skeletal Radiology, 2024, 53(10): 2081-2097.

[9] Jain A K, Rajasekaran S, Jaggi K R, et al. Tuberculosis of the Spine
[J]. Journal of Bone and Joint Surgery, 2020, 102(7): 617-628.

[10] Kubihal, V, Sharma, R, Krishna Kumar, RG, et al. Imaging update in spinal tuberculosis
[J]. Journal of Clinical Orthopaedics and Trauma, 2022, 25: 101742.

[11] Pattamapaspong, N, Kanthawang, T, Bouaziz, MC, et al. Imaging of musculoskeletal tuberculosis
[J]. British Journal of Radiology, 2024, 97(1153): 1-12.

引用本文

刘佩, 郑盛. 非典型临床表现脊柱结核合并冷脓肿1例 [J]. 国际临床研究杂志. 2025; 9; (8). 10 - 17.

文献评论

相关学者

相关机构