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Spinal Abscess Caused by Salmonella Bacteremia in a Patient with Primary Myelofibrosis

Shehab Fareed, Abdulqadir J. Nashwan, Sulieman Abu Jarir, Ahmed Husain, Dina Sameh Suliman, Friyal Ibrahim, Abbas Moustafa, Muhammad S. Akhter, Mohamed A. Yassin

(Department of Oncology and Hematology, National Center for Cancer Care and Research (NCCCR) – Hamad Medical Corporation (HMC), Doha, Qatar)

Am J Case Rep 2017; 18:859-864

DOI: 10.12659/AJCR.903482


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.

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