Delayed surgical site infection after posterior cervical instrumented surgery in a patient with atopic dermatitis: a case report

DOI Web Site 参考文献18件
  • Takahashi Hiroshi
    Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan Department of Orthopaedic Surgery, University of Tsukuba, Japan
  • Aoki Yasuchika
    Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Japan
  • Taniguchi Shinji
    Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan
  • Nakajima Arata
    Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan
  • Sonobe Masato
    Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan
  • Akatsu Yorikazu
    Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan
  • Saito Junya
    Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan
  • Yamada Manabu
    Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan
  • Shiga Yasuhiro
    Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan
  • Inage Kazuhide
    Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan
  • Orita Sumihisa
    Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan
  • Eguchi Yawara
    Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan
  • Maki Satoshi
    Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan
  • Furuya Takeo
    Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan
  • Akazawa Tsutomu
    Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Japan
  • Koda Masao
    Department of Orthopaedic Surgery, University of Tsukuba, Japan
  • Yamazaki Masashi
    Department of Orthopaedic Surgery, University of Tsukuba, Japan
  • Ohtori Seiji
    Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan
  • Nakagawa Koichi
    Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan

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<p>Objective: Atopic dermatitis (AD) is one of the known risk factors for Staphylococcus aureus infection. The authors report the case of a patient with cervical spondylosis and AD who developed delayed surgical site infection after posterior cervical instrumented surgery.</p><p>Patient: A 39-year-old male presented to our hospital with paralysis of the left upper extremity without any cause or prior injury. He had a history of severe AD. We performed C3–C7 posterior decompression and instrumented fusion based on the diagnosis of cervical spondylotic amyotrophy. One year after surgery, his deltoid and bicep muscle strength were fully recovered. Nevertheless, his neck pain worsened 2 years after surgery following worsening of AD. One month after that, he developed severe myelopathy and was admitted to our hospital. Radiographic findings showed that all the screws had loosened and the retropharyngeal space had expanded. Magnetic resonance imaging and computed tomography showed severe abscess formation and destruction of the C7/T1 vertebrae.</p><p>Result: We diagnosed him with delayed surgical site infection. Methicillin-resistant Staphylococcus aureus was identified on abscess culture. The patient responded adequately to treatment with antibiotic therapy and two debridements and the infection subsided.</p><p>Conclusion: We should consider the possibility of delayed surgical site infection when conducting instrumented spinal surgery in patients with severe AD.</p>

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