We describe a 75-year-old male patient who developed a general syndrome, with a fever of 39 degrees C, weight loss, and cervical pain, during the month following a urological procedure. The presence of positive blood cultures for Enterococcus faecalis, aortic vegetations, and severe aortic regurgitation observed with echocardiogram confirmed the diagnosis of infective endocarditis (IE). Magnetic resonance imaging of the spinal cord showed significant erosion and irregularities of the odontoid apophysis, with hyperintensity of bone marrow in T2-weighted images because of edema and inflammation. These findings suggested an infective necrosis of the odontoid apophysis. Despite the common occurrence of rheumatologic manifestations in IE, with prevalence rates of 25% to 44%, spondylodiscitis is rarely observed (5%-13%). The lumbar region is the most commonly involved. We found only one other reported case of cervical spondylodiscitis. The case we describe is the first report of septic necrosis of the odontoid apophysis associated with IE.

译文

我们描述了一名75岁的男性患者,该患者在泌尿外科手术后的一个月内出现了一般综合征,发热39摄氏度,体重减轻和宫颈疼痛。超声心动图观察到粪肠球菌,主动脉植被和严重的主动脉反流的阳性血培养物证实了感染性心内膜炎 (IE) 的诊断。脊髓的磁共振成像显示出齿状突突的明显侵蚀和不规则,由于水肿和炎症,T2-weighted图像中的骨髓强度高。这些发现表明齿状突突的感染性坏死。尽管IE中常见的风湿病表现,患病率为25% 至44%,但很少观察到椎间盘炎 (5%-13%)。腰部是最常见的累及部位。我们只发现了另外一例颈椎炎病例。我们描述的病例是与IE相关的齿状突突的败血性坏死的首次报道。

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