Abstract

Melioidosis rarely presents with spinal involvement, which may lead to neurological complications. It's endemic to Thailand and Australia, but rare in India. Patients with diabetes, immunocompromised states, and chronic renal failure are at high risk of developing melioidosis, which can present with localized or disseminated abscess collection. We reported two patients. One was a 37-year-old male with Type 2 Diabetes Mellitus who was transported to D10 SEA with a Paraspinal collection at L2–L4, but without vertebral body involvement. The other patient was a 64-year-old male with Type 2 Diabetes Mellitus who had Grade 2 spondylolisthesis L5S1 with sacroiliitis. Both patients underwent minimally invasive decompression, and the second patient also received unilateral fixation. We sent the materials for histopathology, biopsy, pus c/s, fungal c/s, Genexpert, gram stain, and AFB stain. However, both patients developed hypotensive shock intraoperatively and were monitored in the ICU. Meliodosis is a rare disease in the Indian subcontinent that can manifest as a spinal epidural abscess with spondylodiscitis. It is important to consider this disease in immunocompromised, diabetic, or chronically renal diseased patients. Adequate intraoperative and postoperative management is crucial to prevent mortality.

中文翻译：

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脊柱类鼻疽表现为脊柱硬膜外脓肿的术中心血管急症：2 例患者的罕见病例研究

摘要

类鼻疽很少出现脊柱受累，这可能导致神经系统并发症。它是泰国和澳大利亚的特有种，但在印度很少见。患有糖尿病、免疫功能低下和慢性肾功能衰竭的患者患类鼻疽的风险很高，可能会出现局部或播散性脓肿聚集。我们报告了两名患者。其中一名 37 岁男性患有 2 型糖尿病，他被送往 D10 SEA，并在 L2-L4 处收集了椎旁椎体，但没有椎体受累。另一名患者是一名 64 岁男性，患有 2 型糖尿病，患有 2 级腰椎滑脱 L5S1 并伴有骶髂关节炎。两名患者均接受了微创减压，第二名患者也接受了单侧固定。我们寄去了组织病理学、活检、脓液c/s、真菌c/s、Genexpert、革兰氏染色和AFB染色的材料。然而，两名患者均在术中出现低血压休克，并在 ICU 接受监测。类鼻疽是印度次大陆的一种罕见疾病，可表现为伴有椎间盘炎的脊柱硬膜外脓肿。在免疫功能低下、糖尿病或慢性肾病患者中考虑这种疾病很重要。充分的术中和术后管理对于预防死亡至关重要。