Shimane Journal of Medical Science

Shimane University Faculty of Medicine
ISSN :0386-5959(in print)
ISSN :2433-2410(online)

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Shimane Journal of Medical Science 34 2
2017-12-31 発行

Pyogenic Spondylitis Accompanied by Urinary Tract Infection and Septic Arthritis of the Knee: A Case Report

Kato, Ayako Postgraduate Clinical Training Center
Takinami, Yoshikazu Department of Emergency and Critical Care Medicine
Kodani, Nobuhiro Department of Emergency and Critical Care Medicine
Nishina, Masayosi Department of Emergency and Critical Care Medicine
Kanayama, Hidekazu Department of Radiology, shimane University Hospital
Yamamoto, Nobuko Department of Radiology, shimane University Hospital
Kuwata, Suguru Department of Orthopedics
Ito, Reiji Department of Orthopedics
Takuwa, Hiroshi Department of Orthopedics
Matuzaki, Masahiko Department of Orthopedics
Uchio, Yuji Department of Orthopedics
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Description
Vertebral spondylitis is difficult to diagnose and
is often treated as fever of unknown origin. We
encountered a 46-year-old man with complaints of
fever and back pain. He had costovertebral angle
tenderness on percussion and elevated inflammatory
markers on blood biochemistry; he was suspected to
have urinary tract infection. A likely cause of fever,
such as pyelonephritis, was elusive on non-contrast
chest/abdomen/pelvis computed tomography and subsequent
contrast computed tomography and magnetic
resonance imaging. Specialist radiology review was
suggestive of vertebral spondylitis. Physical reexamination
revealed numbness and muscle weakness consistent
with the location of the lesions. Conservative
antibiotic treatment was initiated. Septic right knee
joint was also suspected, and arthroscopic washout
with débridement was urgently performed. Inflammatory
markers improved on conservative antibiotic
treatment. In emergency settings, thorough physical
examination and coordination between medical specialists
is crucial.
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Faculty of Medicine, Shimane University