Extreme systemic inflammatory response syndrome instantly after spinal surgical procedure in a affected person with axial gout.
BMJ Case Rep. 2018 Jan 24;2018:
Authors: Gago R, Vilá S, Vélez-Rivera J, Vilá LM
We report a 55-year-old man with gouty arthritis who developed a Three-month historical past of low again ache, gradual decrease extremities weak spot and urinary incontinence. Lumbar MRI confirmed an exophytic lesion at L3-L4. Instantly after spinal decompression surgical procedure, he developed fever, disorientation, polyarthritis, acute kidney harm and leucocytosis. He was handled with a number of antimicrobial brokers for presumed spinal abscess however didn’t enhance. A number of physique web site cultures have been unfavorable. Aspiration of the sacroiliac joint revealed the presence of monosodium uric acid crystals. A analysis of acute gout was executed, and he was handled with high-dose intravenous methylprednisolone and colchicine. Inside 48?hours, he had a outstanding medical enchancment. At discharge, neurological and laboratory abnormalities had resolved. Consciousness of danger elements for axial gout and a excessive diploma of suspicion are vital to ascertain a immediate analysis and remedy to stop extreme issues as seen on this case.
PMID: 29367221 [PubMed – in process]