04 August 2017 : Case report
Spinal Abscess Caused by Salmonella Bacteremia in a Patient with Primary Myelofibrosis
Challenging differential diagnosis, Rare coexistence of disease or pathology
Shehab Fareed1ABDEF*, Abdulqadir J. Nashwan1ABDEF, Sulieman Abu Jarir2DE, Ahmed Husain2DE, Dina Sameh Suliman3DE, Friyal Ibrahim3DE, Abbas Moustafa4DE, Muhammad S. Akhter5DE, Mohamed A. Yassin1DEDOI: 10.12659/AJCR.903482
Am J Case Rep 2017; 18:859-864
Abstract
BACKGROUND: In Primary Myelofibrosis (PMF; a clonal disorder arising from the neoplastic transformation of early hematopoietic stem cells) patients, spinal cord compression (SCC) is a common complication or even a presentation symptom due to extramedullary hematopoiesis (EMH). However, a case of SCC caused by a spinal abscess is unusual. To the best of our knowledge, this is the first case report of this rare condition.
CASE REPORT: We are reporting the case of a 50-year-old male with primary myelofibrosis and long-standing splenomegaly with back pain as a presenting symptom who was found to have spinal cord compression. An MRI was performed, as EMH was suspected. The blood cultures revealed an infection with Salmonella, so the patient was placed on ceftriaxone, with no response. The patient demonstrated substantial clinical improvement after 2 weeks of neurosurgical intervention and pain management.
CONCLUSIONS: In PMF patients, back pain with fever or mild neurological symptoms needs to be investigated urgently because of the high risk of irreversible spinal cord damage leading to partial or complete loss of functional independence and shortened survival. The compression could be related to EMH or infections due to an immunodeficiency.
Keywords: Epidural Abscess, primary myelofibrosis, Salmonella Infections, Spinal Cord Compression
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