array:22 [
  "pii" => "S2173574323000382"
  "issn" => "21735743"
  "doi" => "10.1016/j.reumae.2022.11.003"
  "estado" => "S300"
  "fechaPublicacion" => "2023-04-01"
  "aid" => "1648"
  "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología"
  "copyrightAnyo" => "2022"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "Reumatol Clin. 2023;19:232-3"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2173574323000291"
    "issn" => "21735743"
    "doi" => "10.1016/j.reumae.2023.03.002"
    "estado" => "S300"
    "fechaPublicacion" => "2023-04-01"
    "aid" => "1649"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Reumatol Clin. 2023;19:229-31"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Osteoarticular tuberculosis mortality in Spain between 1997 and 2018"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "229"
          "paginaFinal" => "231"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Mortalidad de la tuberculosis osteoarticular en Espa&#241;a entre 1997 y 2018"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Isabel Le&#243;n Rubio, Antonio Guerrero Espejo"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Isabel"
              "apellidos" => "Le&#243;n Rubio"
            ]
            1 => array:2 [
              "nombre" => "Antonio"
              "apellidos" => "Guerrero Espejo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1699258X22002261"
        "doi" => "10.1016/j.reuma.2022.09.003"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X22002261?idApp=UINPBA00004M"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574323000291?idApp=UINPBA00004M"
    "url" => "/21735743/0000001900000004/v1_202304141104/S2173574323000291/v1_202304141104/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>"
    "titulo" => "Thoracic spondylodiscitis due to lung-spinal fistula from a cavitating lung injury"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "232"
        "paginaFinal" => "233"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Rami Qanneta, Graciano Garc&#237;a-Pardo"
        "autores" => array:2 [
          0 => array:4 [
            "nombre" => "Rami"
            "apellidos" => "Qanneta"
            "email" => array:1 [
              0 => "rqanneta.gipss@gencat.cat"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Graciano"
            "apellidos" => "Garc&#237;a-Pardo"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Internal Medicine&#44; Hospital Viamed Monegal&#44; Tarragona&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Internal Medicine&#44; Hospital Sociosanitari Francol&#237;&#44; GiPSS&#44; Tarragona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Internal Medicine&#44; Hospital Universitari de Tarragona Joan XXIII&#44; Tarragona&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Espondilodiscitis tor&#225;cica secundaria a f&#237;stula pulmono-espinal por lesi&#243;n pulmonar cavitada"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1950
            "Ancho" => 2340
            "Tamanyo" => 312446
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Chest X-ray&#58; right paratracheal infiltrates&#46; &#40;B&#41; Chest CT&#58; right lung consolidation occupying the azygo-esophageal recess&#44; with aire-fluid level and calcium deposits&#44; as well as a marked crush and destructuring located at the T5-T6&#46; &#40;C&#41; Thoracic spine MRI &#40;coronal&#41;&#58; central necrotic-cystic zone occupyping the disc space of the T5-T6 and fistulous communication with the adjacent right lung injury&#46; &#40;D&#41; Thoracic spine MRI &#40;sagittal&#41;&#58; diffuse gadolinium enhancement and kyphotic deformity with canal stenosis located at the T5-T6&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A Caucasian 72-year-old man with chronic obstructive pulmonary disease and paraparesis caused by thoracic spinal cord injury due to traffic accident twenty-five years ago&#46; He presented to the emergency room with one week of cough with purulent sputum&#44; dyspnea with 88 percent of blood oxygen saturation&#44; intermittent fever up to 38<span class="elsevierStyleHsp" style=""></span>&#176;C and worsening of bilateral lower limbs weakness&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Physical examination was notable for crackles on auscultation in the upper and middle fields of the right lung&#44; as well as spastic paraparesis with normal rectal tone&#46; Blood test showed increased C-reactive protein 15<span class="elsevierStyleHsp" style=""></span>mg&#47;dL &#40;reference range 0&#46;5&#8211;1&#41;&#46; Chest X-ray showed right paratracheal infiltrates &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#46; Chest CT showed cavitating right lung consolidation and crush located at T5-T6 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#46; Thoracic spine MRI showed lung-spinal fistula and signs suggestive of spondylodiscitis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C and D&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">An empirical antibiotic treatment was initiated with intravenous piperacillin&#8211;tazobactam for a presumed bacterial thoracic spondylodiscitis related to contiguous right-side cavitating pneumonia&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1&#44;2</span></a> Microbiological investigations were all negative&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">To pursue definitive diagnosis&#44; the patient underwent evaluation for percutaneous CT-guided spinal needle biopsy&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a> However&#44; he died on the seventh-day hospital stay due to massive hemoptysis and irrecoverable cardiac arrest&#46; The family of the patient refused autopsy&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare they have no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflict of interests"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2022-09-21"
    "fechaAceptado" => "2022-11-02"
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1950
            "Ancho" => 2340
            "Tamanyo" => 312446
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Chest X-ray&#58; right paratracheal infiltrates&#46; &#40;B&#41; Chest CT&#58; right lung consolidation occupying the azygo-esophageal recess&#44; with aire-fluid level and calcium deposits&#44; as well as a marked crush and destructuring located at the T5-T6&#46; &#40;C&#41; Thoracic spine MRI &#40;coronal&#41;&#58; central necrotic-cystic zone occupyping the disc space of the T5-T6 and fistulous communication with the adjacent right lung injury&#46; &#40;D&#41; Thoracic spine MRI &#40;sagittal&#41;&#58; diffuse gadolinium enhancement and kyphotic deformity with canal stenosis located at the T5-T6&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:3 [
            0 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Espondilodiscitis infecciosa"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Oropesa Juanes"
                            1 => "M&#46;I&#46; Gonz&#225;lez-Cruz"
                            2 => "J&#46; Calvo Catal&#225;"
                            3 => "C&#46; Campos Fern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1699-258X(08)71818-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Reumatol Clin"
                        "fecha" => "2008"
                        "volumen" => "4"
                        "paginaInicial" => "126"
                        "paginaFinal" => "127"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21794515"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pyogenic spondylodiscitis due to pleurovertebral fistula complicating radiofrequency ablation of pulmonary carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;R&#46; Ferretti"
                            1 => "F&#46; Arbib"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.diii.2014.11.032"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diagn Interv Imaging"
                        "fecha" => "2015"
                        "volumen" => "96"
                        "paginaInicial" => "511"
                        "paginaFinal" => "513"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25704148"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "CT-guided needle biopsy in vertebral osteomyelitis&#58; study of factors that could influence in culture yield"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;J&#46; Frag&#237;o Gil"
                            1 => "R&#46; Gonz&#225;lez Mazar&#237;o"
                            2 => "J&#46; Ivorra Cort&#233;s"
                            3 => "A&#46;J&#46; Ca&#241;ada Mart&#237;nez"
                            4 => "M&#46; Salavert Lleti"
                            5 => "J&#46;A&#46; Rom&#225;n Ivorra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.reumae.2020.08.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Reumatol Clin"
                        "fecha" => "2022"
                        "volumen" => "18"
                        "paginaInicial" => "20"
                        "paginaFinal" => "24"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35090608"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735743/0000001900000004/v1_202304141104/S2173574323000382/v1_202304141104/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "5795"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Images in Clinical Rheumatology"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001900000004/v1_202304141104/S2173574323000382/v1_202304141104/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574323000382?idApp=UINPBA00004M"
]
Share
Journal Information
Vol. 19. Issue 4.
Pages 232-233 (April 2023)
Share
Share
Download PDF
More article options
Vol. 19. Issue 4.
Pages 232-233 (April 2023)
Images in Clinical Rheumatology
Full text access
Thoracic spondylodiscitis due to lung-spinal fistula from a cavitating lung injury
Espondilodiscitis torácica secundaria a fístula pulmono-espinal por lesión pulmonar cavitada
Visits
916
Rami Qannetaa,b,
Corresponding author
rqanneta.gipss@gencat.cat

Corresponding author.
, Graciano García-Pardoa,c
a Internal Medicine, Hospital Viamed Monegal, Tarragona, Spain
b Internal Medicine, Hospital Sociosanitari Francolí, GiPSS, Tarragona, Spain
c Internal Medicine, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
This item has received
Article information
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Full Text

A Caucasian 72-year-old man with chronic obstructive pulmonary disease and paraparesis caused by thoracic spinal cord injury due to traffic accident twenty-five years ago. He presented to the emergency room with one week of cough with purulent sputum, dyspnea with 88 percent of blood oxygen saturation, intermittent fever up to 38°C and worsening of bilateral lower limbs weakness.

Physical examination was notable for crackles on auscultation in the upper and middle fields of the right lung, as well as spastic paraparesis with normal rectal tone. Blood test showed increased C-reactive protein 15mg/dL (reference range 0.5–1). Chest X-ray showed right paratracheal infiltrates (Fig. 1A). Chest CT showed cavitating right lung consolidation and crush located at T5-T6 (Fig. 1B). Thoracic spine MRI showed lung-spinal fistula and signs suggestive of spondylodiscitis (Fig. 1C and D).

Fig. 1.

(A) Chest X-ray: right paratracheal infiltrates. (B) Chest CT: right lung consolidation occupying the azygo-esophageal recess, with aire-fluid level and calcium deposits, as well as a marked crush and destructuring located at the T5-T6. (C) Thoracic spine MRI (coronal): central necrotic-cystic zone occupyping the disc space of the T5-T6 and fistulous communication with the adjacent right lung injury. (D) Thoracic spine MRI (sagittal): diffuse gadolinium enhancement and kyphotic deformity with canal stenosis located at the T5-T6.

(0.3MB).

An empirical antibiotic treatment was initiated with intravenous piperacillin–tazobactam for a presumed bacterial thoracic spondylodiscitis related to contiguous right-side cavitating pneumonia.1,2 Microbiological investigations were all negative.

To pursue definitive diagnosis, the patient underwent evaluation for percutaneous CT-guided spinal needle biopsy.3 However, he died on the seventh-day hospital stay due to massive hemoptysis and irrecoverable cardiac arrest. The family of the patient refused autopsy.

Conflict of interests

The authors declare they have no conflict of interest.

References
[1]
R. Oropesa Juanes, M.I. González-Cruz, J. Calvo Catalá, C. Campos Fernández.
Espondilodiscitis infecciosa.
Reumatol Clin, 4 (2008), pp. 126-127
[2]
G.R. Ferretti, F. Arbib.
Pyogenic spondylodiscitis due to pleurovertebral fistula complicating radiofrequency ablation of pulmonary carcinoma.
Diagn Interv Imaging, 96 (2015), pp. 511-513
[3]
J.J. Fragío Gil, R. González Mazarío, J. Ivorra Cortés, A.J. Cañada Martínez, M. Salavert Lleti, J.A. Román Ivorra.
CT-guided needle biopsy in vertebral osteomyelitis: study of factors that could influence in culture yield.
Reumatol Clin, 18 (2022), pp. 20-24
Copyright © 2022. Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología
Download PDF
Idiomas
Reumatología Clínica (English Edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?