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2012, vol. 69, br. 12, str. 1109-1113
Subduralni tuberkulozni apsces lumbalne kičme kod bolesnice sa hroničnim lumbalnim sindromom
aVojnomedicinska akademija, Klinika za infektivne i tropske bolesti, Beograd + Univerzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd
bVojnomedicinska akademija, Klinika za neurohirurgiju, Beograd + Univerzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd
cVojnomedicinska akademija, Beograd

e-adresadrmikic@gmail.com
Ključne reči: tuberkuloza; apses; subduralni prostor; pršljenovi, lumbalni; dijagnoza, diferencijalna
Sažetak
Uvod. Subduralni tuberkulozni apsces kičme može biti nedijagnostikovan i praćen neurološkim komplikacijama sve do paraplegije, uprkos modernim radiološkim metodama. Prikazan je izuzetno redak slučaj subduralnog tuberkuloznog apscesa lumbalne (L) kičme sa paraparezom, kod imunokompetentne bolesnice, stare 49 godina. Prikaz bolesnika. Bolesnica sa hroničnim L-sindromom i anamnezom o operacijama intervertebralnog (IV) diska L3 i L5 dobila je jake bolove u L-kičmi krajem jula 2007. Istovremeno, imala je i gnojnu kolekciju u predelu levog kolena. Lečena je visokim dozama kortikosteroida i antibioticima. Tada je dobila visoku temperaturu, uz pojačanje intenziteta bola u L-kičmi i razvoj parapareze. Sedimentacija eritrocita bila je 108 mm/1 h, C-reaktivni protein 106,0 mg/L, leukociti 38,4 x 109/L sa skretanjem ulevo. Magnetnom rezonancom (MR) L-kičme u spinalnom kanalu, počev od IV diska L2 do polovine tela pršljena L4 registrovana je ekspanzivna formacija. Nalaz je ukazivao na ekstruziju i sekvestraciju IV diska u nivou IV prostora L3 sa kranijalnom i kaudalnom migracijom. Urađena je hitna neurohirurška operacija koja je pokazala da se radi o subduralnom stafilokoknom apscesu L-kičme. Prema antibiogramu primenjena je antibiotska terapija, ali bez efekta na tok bolesti. Kontrolna MR L-kičme pokazala je spondilodiscitis L3 i L4 pršljena, apscesnu kolekciju u spinalnom kanalu i apsces paravertebralne muskulature. Krajem septembra 2007 urađena je iglena biopsija tela L3 pršljena vođena kompjuterizovanom tomografijom i dokazani su acidorezistentni bacili. U terapiju su uključeni tuberkulostatici. Dve godine kasnije bolesnica je bila bez značajnijih subjektivnih tegoba, sa normalnim kliničkim, laboratorijskim i morfološkim nalazima. Zaključak. Subduralni tuberkulozni apsces kičme je ekstremno retka manifestacija tuberkuloze kičme. Tačna i rana dijagnoza i adekvatna terapija atipične forme tuberkuloze kičme ključni su faktori dobre prognoze.
Reference
Alessi, G., Lemmerling, M., Nathoo, N. (2003) Combined spinal subdural tuberculous empyema and intramedullary tuberculoma in an HIV-positive patient. European radiology, 13(8): 1899-901
American Thoracic Society-Centers for Disease Control and Prevention-Infectious Diseases Society of America (2005) Controlling tuberculosis in the United States. American Journal of Respiratory and Critical Care Medicine, 172(9): 1169-1227
Azzam, N.I., Tammawy, M. (1988) Tuberculous spondylitis in adults: Diagnosis and treatment. British journal of neurosurgery, 2(1): 85-91
Bakhsh, A. (2010) Medical Management of Spinal Tuberculosis. Spine, 35(16): E787-E791
Chang, M., Wu, H.T.H., Lee, C., Liu, C., Chen, T. (2006) Tuberculous spondylitis and pyogenic spondylitis: Comparative magnetic resonance imaging features. Spine, 31(7): 782-8
Cotten, A., Flipo, R.M., Drouot, M.H., Maury, F., Chastanet, P., Duquesnoy, B., Delcambre, B. (1996) Spinal tuberculosis. Study of clinical and radiological aspects from a series of 82 cases. Journal de radiologie, 77(6): 419-26
Dass, B., Puet, T.A., Watanakunakorn, C. (2002) Tuberculosis of the spine (Pott's disease) presenting as 'compression fractures'. Spinal cord, 40(11): 604-8
Devi, I.B., Chandra, S., Mongia, S., Chandramouli, B.A., Sastry, K.V.R., Shankar, S.K. (2002) Spinal intramedullary tuberculoma and abscess: A rare cause of paraparesis. Neurology India, 50(4): 494-6
Douglas, J.G., McLeod, M.J. (1999) Pharmacokinetic factors in the modern drug treatment of tuberculosis. Clinical pharmacokinetics, 37(2): 127-46
Emel, E., Güzey, F.K., Güzey, D., Bas, S.N., Sel, B., Alatas, I. (2006) Non-contiguous multifocal spinal tuberculosis involving cervical, thoracic, lumbar and sacral segments: A case report. European spine journal, 15(6): 1019-24
Harsha, S.C.K., Shetty, A.P., Rajasekaran, S. (2006) Intradural spinal tuberculosis in the absence of vertebral or meningeal tuberculosis: A case report. J Orthop Surg (Hong Kong), 14(1); 71-5
Hwang, C.M., Shin, M.J., Kim, S.M., Lee, S.H., Lee, S.M., Shin, J.H., i dr. (2003) The Diagnostic sefulness of CT-guided Needle Biopsy or Aspiration in Infectious Spondylitis. J Korean Radiol Soc, 48(6); 497-504
Jain, A.K. (2010) Tuberculosis of the spine: A fresh look at an old disease. Journal of bone and joint surgery. British volume, 92(7): 905-13
Janssens, J.P., de Haller, R. (1990) Spinal tuberculosis in a developed country. A review of 26 cases with special emphasis on abscesses and neurologic complications. Clinical orthopaedics and related research, (257): 67-75
Jung, N., Jee, W., Ha, K., Park, C., Byun, J. (2004) Discrimination of tuberculous spondylitis from pyogenic spondylitis on MRI. AJR. American journal of roentgenology, 182(6): 1405-10
Kim, M.S., Kim, K.J., Chung, C.K., Kim, H.J. (2000) Intradural extramedullary tuberculoma of the spinal cord: A case report. Journal of Korean medical science, 15(3): 368-70
Kotil, K., Alan, S.M., Bilge, T. (2007) Medical management of Pott disease in the thoracic and lumbar spine: A prospective clinical study. Journal of neurosurgery. Spine, 6(3): 222-8
Leibert, E., Haralambou, G. (2004) Tuberculosis. u: Rom W.N., Garay S.M. [ur.] Spinal tuberculosis, Philadelphia: Lippincott, Williams and Wilkins, p. 565-77
Lindahl, S., Nyman, R.S., Brismar, J., Hugosson, C., Lundstedt, C. (1996) Imaging of tuberculosis. IV. Spinal manifestations in 63 patients. Acta radiologica, 37(4): 506-11
Maron, R., Levine, D., Dobbs, T.E., Geisler, W.M. (2006) Two Cases of Pott Disease Associated With Bilateral Psoas Abscesses. Spine, 31(16): E561-E564
Mclaughlin, M.R., Jannetta, P.J., Clyde, B.L., Subach, B.R., Comey, C.H., Resnick, D.K. (1999) Microvascular decompression of cranial nerves: Lessons learned after 4400 operations. Journal of Neurosurgery, 90(1): 1-8
Miyamoto, J., Sasajima, H., Owada, K., Odake, G., Mineura, K. (2003) Spinal Intramedullary Tuberculoma Requiring Surgical Treatment-Case Report-. Neurologia medico-chirurgica, 43(11): 567-571
Mondal, A. (1994) Cytological diagnosis of vertebral tuberculosis with fine-needle aspiration biopsy. Journal of bone and joint surgery. American volume, 76(2): 181-4
Nussbaum, E.S., Rockswold, G.L., Bergman, T.A., Erickson, D.L., Seljeskog, E.L. (1995) Spinal tuberculosis: A diagnostic and management challenge. Journal of neurosurgery, 83(2): 243-7
Ozates, M., Ozkan, U., Kemaloglu, S., Hosoglu, S., Sari, I. (2000) Spinal subdural tuberculous abscess. Spinal Cord, 38(1): 56-58
Pande, K.C., Babhulkar, S.S. (2002) Atypical Spinal Tuberculosis. Clinical Orthopaedics and Related Research, 398: 67-74
Pertuiset, E., Beaudreuil, J., Liote, F., Horusitzky, A., Kemiche, F., Richette, P., Clerc-Wyel, D., Cerf-Payrastre, I., Dorfmann, H., Glowinski, J., Crouzet, J., Bardin, T., Meyer, O., Dryll, A., Ziza, J.M., Kahn, M.F., Kuntz, D. (1999) Spinal tuberculosis in adults. A study of 103 cases in a developed country, 1980-1994. Medicine, 78(5): 309-20
Rahman, N. (1980) Atypical forms of spinal tuberculosis. Journal of bone and joint surgery. British volume, 62-B(2): 162-5
Rahman, N., El-Bakry, A., Jamjoom, A., Jamjoom, Z.A., Kolawole, T.M. (1999) Atypical forms of spinal tuberculosis: Case report and review of the literature. Surgical neurology, 51(6): 602-7
Rezai, A.R., Lee, M., Cooper, P.R., Errico, T.J., Koslow, M. (1995) Modern management of spinal tuberculosis. Neurosurgery, 36(1): 87-97; discussion 97-8
Sarangapani, A., Fallah, A., Provias, J., Jha, N.K. (2008) Atypical presentation of spinal tuberculosis. Canadian journal of surgery. Journal canadien de chirurgie, 51(6): E121
Savic, M., Antic, B., Roganovic, Z. (1997) Spinal subdural abscess: A case report. Clinical Neurology and Neurosurgery, 99 (Suppl 1): 184
Semlali, S., Akjouj, S., Chaouir, S., Hanine, A., Ben, A.M. (2007) Spinal subdural tuberculous abscess in a patient with tuberculous meningitis. Journal de Radiologie, 88(2): 280-281
Sinha, S., Singh, A.K., Gupta, V., Singh, D., Takayasu, M., Yoshida, J. (2003) Surgical management and outcome of tuberculous atlantoaxial dislocation: A 15-year experience. Neurosurgery, 52(2): 331-8; discussion 338-9
Skendros, P., Kamaria, F., Kontopoulos, V., Tsitouridis, I., Sidiropoulos, L. (2003) Intradural, eextramedullary tuberculoma of the spinal cord as a complication of tuberculous meningitis. Infection, 31(2): 115-7
Sucu, H.K., Ciçek, C., Rezanko, T., Bezircioğlu, H., Erşahin, Y., Tunakan, M., Minoğlu, M. (2006) Percutaneous computed-tomography-guided biopsy of the spine: 229 procedures. Joint, bone, spine, 73(5): 532-7
Tanriverdi, T., Kizilkiliç, O., Hanci, M., Kaynar, M.Y., Unalan, H., Oz, B. (2003) Atypical intradural spinal tuberculosis: Report of three cases. Spinal cord, 41(7): 403-9
Teegala, R., Kumar, P., Kale, S.S., Sharma, B.S. (2008) Craniovertebral junction tuberculosis: A new comprehensive therapeutic strategy. Neurosurgery, 63(5): 946-55; discussion 955
Tuli, S.M., Srivastava, T.P., Varma, B.P., Sinha, G.P. (1967) Tuberculosis of spine. Acta orthopaedica Scandinavica, 38(4): 445-58
Velissaris, D., Aretha, D., Fligou, F., Filos, K.S. (2009) Spinal Subdural Staphylococcus Aureus Abscess: Case report and review of the literature. World J Emerg Surg., 6 (31):
Wasay, M., Arif, H., Khealani, B., Ahsan, H. (2006) Neuroimaging of tuberculous myelitis: Analysis of ten cases and review of literature. Journal of neuroimaging, 16(3): 197-205
 

O članku

jezik rada: engleski
vrsta rada: prikaz slučaja
DOI: 10.2298/VSP1212109M
objavljen u SCIndeksu: 03.12.2012.
metod recenzije: dvostruko anoniman

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