Implant Infection after Lumbar Metal Stents Fixation：A Case Report and Literature Review

WANG Yue-yue; ZHU Hai-yan; GUO Ming-guang; SONG Yang; MENG Qing-yi

doi:10.3969/j.issn.1002-3429.2015.03.17

Abstract：Objective To explore clinical characteristics, key points of diagnosis and treatment of implant infections. Methods Clinical data of one patient with implant infection were retrospectively analyzed and related literature was also re-viewed. Results The patient was admitted for abdominal pain, lumbago and fever and was examined with ultrasonography, CT and laboratory testing in other institutions, for intestinal obstruction. The patient received treatment of gastrointestinal de-compression and antibiotics, but his symptoms had no mitigation. After being admitted to our emergency department, the pa-tient was examined with pathogen and MRI. Combining with the history of lumbar metal stents fixation, clinicians revised the diagnosis to psoas abscess and hematoma, and spine implant infection was suspected. The patient received treatments inclu-ding topical percutaneous puncture catheter drainage, anti-infection treatment according to the results of blood culture and drug sensitivity, intravenous fluids, abatement of fever and other symptomatic therapy, the symptoms were alleviated. The patient family insisted that the patient be sent back to a local hospital for treatment. Clinical follow up for one month revealed that de-finitive diagnosis was implant infection after lumbar metal stents fixation. After the patient underwent surgery to remove the im-plant combined with anti-infection therapy based on pathogen-detecting results, the patient recovered. Conclusion The early clinical manifestation of implant infections lacks specificity, and the disease is apt to be misdiagnosed. After eliminating other common suspected causes of infection, clinicians should consider the possibility of the disease when the patient has unex-plained symptoms of systemic infection and the medical history of implant infection. Relevant inspections should be carried in time in order to make an early diagnosis of the disease.