微小单胞菌引起腰椎间隙感染:1例报告和综述△

Lumbar intervertebral space infection caused by Parvimonas micra: a case report with literature review

摘要:

微小单胞菌 (Parvimonas micra, P.micra) 是一种革兰氏阳性厌氧球菌，广泛存在于皮肤、口腔黏膜、胃肠道和泌尿生殖系统中。P.micra 在牙源性感染中常见，而罕见于椎间隙感染。椎间隙感染的主要病原菌为金黄色葡萄球菌，其次为链球菌和肠球菌，由 P.micra 引起的椎间隙感染在国内尚无文献报道。本文报告 1 例通过下一代测序技术 (next generation sequenc- ing, NGS)方法确诊 P.micra 腰椎间隙感染合并硬膜外脓肿，采用一期腰椎后路病灶清除+取髂骨及同种异体骨植骨融合内固定术治疗后痊愈的病例，并结合文献复习，总结 P.micra 引起腰椎间隙感染的流行病学特征、发病特点、诊疗经验，为该病的诊疗提供建议。

Abstract:

Parvimonas micra (P. micra.) is a kind of Gram-positive anaerobic bacteria, widely existing in the skin, oral mucosa, gastroin- testinal tract and urogenital system. Although P. micra was common cause in odontogenic infections, there has not been a report about inter- vertebral space infection caused by P. micra in domestic literature, whereas which usually induced by Staphylococcus aureus, followed by streptococcus and enterococcus. We report a case of lumbar intervertebral space infection with epidural abscess caused by P micra con- firmed by next generation sequencing (NGS) and cured after one- stage posterior lumbar debridement combined with instrumented fusion with iliac bone autograft and allograft. Combined with a review of the literature, the epidemiological characteristics, pathogenesis and diagno- sis and treatment experience of lumbar intervertebral space infection caused by P. micra were summarized, in addition, suggestions were put forward for diagnosis and treatment of the disease.