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

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 sequencing,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。

Parvimonas micra(P.micra.) is a kind of Gram-positive anaerobic bacteria,widely existing in the skin,oral mucosa,gastrointestinal tract and urogenital system.Although P.micra was common cause in odontogenic infections,there has not been a report about intervertebral 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 confirmed 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 diagnosis 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.