Zhang D, Gan LY, Zhang WJ, Shi M, Zhang L, Zhang Y, Liu MW. Cervical spine infection arising from chronic paronychia: A case report and review of literature. World J Orthop 2024; 15(12): 1214-1225 [PMID: 39744732 DOI: 10.5312/wjo.v15.i12.1214]
Corresponding Author of This Article
Wen-Jie Zhang, PhD, Department of Orthopedics and Spine, Guangxi University of Traditional Chinese Medicine Affiliated International Zhuang Hospital, No. 8 Qiuyue Road, Wuxiang New District, Nanning 530201, Guangxi Zhuang Autonomous Region, China. gzzw69@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Dec 18, 2024; 15(12): 1214-1225 Published online Dec 18, 2024. doi: 10.5312/wjo.v15.i12.1214
Cervical spine infection arising from chronic paronychia: A case report and review of literature
Dan Zhang, Li-Ying Gan, Wen-Jie Zhang, Ming Shi, Liang Zhang, Yong Zhang, Ming-Wei Liu
Dan Zhang, Ming Shi, Yong Zhang, Ming-Wei Liu, Department of Orthopedics and Spine Surgery, Guangxi University of Traditional Chinese Medicine Affiliated International Zhuang Hospital, Nanning 530201, Guangxi Zhuang Autonomous Region, China
Li-Ying Gan, Department of Clinical Laboratory, Guangxi University of Traditional Chinese Medicine Affiliated International Zhuang Hospital, Nanning 530201, Guangxi Zhuang Autonomous Region, China
Wen-Jie Zhang, Department of Orthopedics and Spine, Guangxi University of Traditional Chinese Medicine Affiliated International Zhuang Hospital, Nanning 530201, Guangxi Zhuang Autonomous Region, China
Liang Zhang, Department of Orthopedics, Clinical Medical College, Yangzhou University, Yangzhou 225001, Jiangsu Province, China
Co-first authors: Dan Zhang and Li-Ying Gan.
Author contributions: Zhang D conceived and designed the study and wrote this manuscript; Gan LY contributed to the literature review and provided insights into the diagnostic process; Zhang D and Gan LY contributed equally to this article, they are the co-first authors of this manuscript; Zhang WJ, Shi M, and Zhang L participated in interpretation of data, helped in drafting the manuscript and critically reviewed the manuscript; Zhang Y and Liu MW provided critical review and revisions to the manuscript; and all authors have read and approved the final manuscript.
Supported by the Guangxi University of Chinese Medicine Doctoral Startup Research Fund Project, No. 2018BS065; and Department of Traditional Chinese Orthopedics, Guangxi International Zhuang Medicine Hospital, No. [2021]33.
Informed consent statement: Informed verbal consent was obtained from the patient to publish this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Jie Zhang, PhD, Department of Orthopedics and Spine, Guangxi University of Traditional Chinese Medicine Affiliated International Zhuang Hospital, No. 8 Qiuyue Road, Wuxiang New District, Nanning 530201, Guangxi Zhuang Autonomous Region, China. gzzw69@163.com
Received: August 27, 2024 Revised: October 24, 2024 Accepted: November 14, 2024 Published online: December 18, 2024 Processing time: 112 Days and 7.1 Hours
Abstract
BACKGROUND
Cervical spine pyogenic infection (CSPI) is a rare and challenging form of spinal infection that is typically caused by pyogenic bacteria and primarily affects the cervical vertebral bodies and surrounding tissues. Given its nonspecific symptoms, such as fever and neck pain, early diagnosis is crucial to prevent severe complications, including spinal cord injury. We report a previously unreported case of acute CSPI arising from chronic paronychia, exploring its diagnostic and therapeutic challenges through a review of the current literature.
CASE SUMMARY
The presented case involved a 15-year-old man with CSPI caused by Staphylococcus aureus, which led to complications including bacteremia and a paronychia-associated abscess. Acute pyogenic infection was initially diagnosed by typical symptoms and blood culture. Fever improved after antibiotic treatment while developing progressive limbs dysfunction. Six days after admission, the patient underwent anterior cervical debridement + autogenous iliac bone graft fusion + plate internal fixation and received 12 weeks of antibiotic treatment after the operation. Re-examination 3 years postoperatively showed that the patient had stable cervical fixation, no significant neck pain or upper limb abnormalities, and normal urinary function.
CONCLUSION
Early imaging findings, laboratory markers, and timely antibiotic treatment are crucial for CSPI management, preventing complications and facilitating recovery.
Core Tip: Cervical spine pyogenic infection can be derived from unexpected sources, such as chronic paronychia. Imaging examination findings and laboratory markers are crucial for timely identification of the infection source. Multidisciplinary collaboration can enhance diagnostic and treatment efficiency. Prompt antibiotic therapy and surgical intervention can prevent severe complications and promote patient recovery. Regular post-operative follow-up is imperative for evaluating the recurrence of infection.
