胃癌手術後中心静脈カテーテル菌血症に起因したと考えられた化膿性脊椎炎の2例

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We report two cases of pyogenic spondylitis caused by central venous catheter (CVC)-induced bacteremia following gastrectomy for gastric cancer. The first case involved a 79-year-old man who underwent distal gastrectomy and partial hepatectomy. The CVC was inserted because of anastomotic leakage following the gastrectomy. The CVC was removed because CVC-induced bacteremia was identified 53 days after insertion of the CVC. The patient developed back pain 2 days after removal of the CVC. Back pain became severe and he complained of difficulty in walking 3 months after removal of the CVC. He was diagnosed as having pyogenic spondylitis. The second case involved an 86-year-old man. The CVC was inserted because of appetite loss after distal gastrectomy. The CVC was removed because CVC-induced bacteremia occurred 23 days after insertion of the CVC. The patient complained of back pain 7 days after removal of the CVC, and was diagnosed to have pyogenic spondylitis. The results of bacterial cultures of the CVC and arterial blood samples were positive; the causative microorganism of the bacteremia was identified in both cases. Considering the microorganism might cause pyogenic spondylitis, we started antibiotic therapy. These patients were discharged very much improved. Caution should be paid to a possible occurrence of pyogenic spondylitis in patients who complain of unexpected back pain following CVC-induced bacteremia.
日本臨床外科学会の論文
2006-01-25

胃癌手術後中心静脈カテーテル菌血症に起因したと考えられた化膿性脊椎炎の2例

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