Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2023; 11(15): 3583-3591
Published online May 26, 2023. doi: 10.12998/wjcc.v11.i15.3583
Pyogenic spondylitis caused by Escherichia coli: A case report and literature review
Lai-Cheng Zou, Jin Qian, Zhen-Yu Bian, Xue-Peng Wang, Tao Xie
Lai-Cheng Zou, Jin Qian, Department of Orthopedic Surgery, The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Zhen-Yu Bian, Xue-Peng Wang, Tao Xie, Department of Orthopedic Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Author contributions: Zou LC conceived and designed the study and wrote this manuscript; Qian J was involved in the management of the patient and prepared the initial draft of the manuscript; Zou LC and Bian ZY participated in interpretation of data, helped in drafting the manuscript and critically reviewed the manuscript; all authors read and approved the final manuscript.
Supported by Medicine and Health Foundation of Zhejiang Province, No. 2021KY864.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case 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: Zhen-Yu Bian, MD, PhD, Chief Doctor, Department of Orthopedic Surgery, Affiliated Hangzhou First People’s Hospital, No. 261 Huansha Road, Shangcheng District, Hangzhou 310006, Zhejiang Province, China. abe-august@163.com
Received: January 4, 2023
Peer-review started: January 4, 2023
First decision: February 17, 2023
Revised: March 4, 2023
Accepted: April 18, 2023
Article in press: April 18, 2023
Published online: May 26, 2023
Abstract
BACKGROUND

Pyogenic spondylitis is often manifested as atypical low back pain and fever, which makes it easy to be confused with other diseases. Here we report a case of pyogenic spondylitis and describe the diagnosis and treatment based on the related literature.

CASE SUMMARY

The reported case suffered from pyogenic spondylitis caused by Escherichia coli and complicated with bacteremia and psoas abscess. Acute pyelonephritis was initially diagnosed due to atypical symptoms. Symptoms were improved from antibiotic treatment while developing progressive lower limb dysfunction. One month post the admission, the patient underwent anterior lumbar debridement + autogenous iliac bone graft fusion + posterior percutaneous screw-rod internal fixation, and received 6 wk of antibiotic treatment after the operation. Reexamination 4 mo post the operation showed that the patient had no evident pain in the waist, and walked well with no evident dysfunction of lower limbs.

CONCLUSION

Here we describe the application value of several imaging examinations, such as X-ray, computed tomography and magnetic resonance imaging, and certain tests like erythrocyte sedimentation rate and C-reactive protein in the clinical treatment of pyogenic spondylitis. This disease requires early diagnosis and treatment. Sensitive antibiotics should be used in early stages and surgical intervention should be taken if necessary, which may help for a speedy recovery and prevent the occurrence of severe complications.

Keywords: Pyogenic spondylitis, Escherichia coli, Diagnosis and treatment, Case report

Core Tip: The reported case suffered from pyogenic spondylitis caused by Escherichia coli and complicated with bacteremia and psoas abscess. Acute pyelonephritis was initially diagnosed due to atypical symptoms. Symptoms were improved from antibiotic treatment while developing progressive lower limb dysfunction. One month post the admission, the patient underwent anterior lumbar debridement + autogenous iliac bone graft fusion + posterior percutaneous screw-rod internal fixation, and received 6 wk of antibiotic treatment after the operation. Reexamination 4 mo post the operation showed that the patient had no evident pain in the waist, and walked well with no evident dysfunction of lower limbs.