Abstract
We report the case of a patient who developed pyogenic spondylitis after surgery for oral floor cancer. This 85-year-old man was evaluated at our hospital for a mass in the left floor of the mouth. Oral floor cancer (T2N0M0) was diagnosed. Surgical resection of the tumor was performed twice. On postoperative day 14, he developed sudden neck pain, followed by fever the next day and a gradual decrease in blood pressure. Septic shock was diagnosed, and echocardiography was performed, but no evidence of infective endocarditis was found. Findings on neck magnetic resonance imaging suggested pyogenic spondylitis, and ultimately pyogenic spondylitis causing septic shock was diagnosed. In patients with a compromised immune system after surgery who develop neck pain and fever, the possibility of pyogenic spondylitis as a complication should be kept in mind.
Highlights
Pyogenic spondylitis (PS) is a rapidly progressive inflammatory disease of the vertebrae with neurological symptoms such as quadriplegia
The incidence of PS has recently increased due to the emergence of resistant bacteria and the increased number of immunocompromised hosts associated with the aging of society [4]
On day 4 after symptom onset, blood pressure was stable at 104/62 mmHg, C-reactive protein (CRP) decreased to 8.25 mg/dl, and the patient was transferred back from the intensive care unit (ICU) to the general ward
Summary
Pyogenic spondylitis (PS) is a rapidly progressive inflammatory disease of the vertebrae with neurological symptoms such as quadriplegia. PS most commonly arises due to hematogenous spread of infection, but PS by direct spread of infection due to a retropharyngeal abscess, stellate ganglion block, or discography has been reported [1]-[3]. The incidence of PS has recently increased due to the emergence of resistant bacteria and the increased number of immunocompromised hosts associated with the aging of society [4]. How to cite this paper: Mano, T., et al (2014) A Case of Pyogenic Spondylitis after Surgery for Oral Floor Cancer. T. Mano et al case of a patient who developed PS, probably due to hematogenous infection, after undergoing surgery for oral floor cancer
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