Typhoid Spondylodiscitis: the First Reported Case in Southeast Asia and Review of the Literature
Gompol Suwanpimolkul MD*, Sumanee Nilgate MSc**, Chusana Suankratay MD, PhD*
Affiliation : * Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ** Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
We describe the first case of typhoid spondylodiscitis in Southeast Asia, and the literature were also reviewed. A 57-year-old diabetic Thai man who presented with a one-month course of progressive low back pain associated with paraparesis and bowel-bladder dysfunction. Examination revealed local tenderness over T12 area, spastic paraparesis, impaired pinprick sensation up to T12 level, and loose anal sphincter tone. Magnetic resonance imaging showed spondylodiscitis of T11 and T12 and epidural abscess causing spinal cord compression. T11 and T12 laminectomy, T11/12 discectomy, and debridement of epidural abscess were performed, and the cultures of the pus grew Salmonella Typhi. He was treated with intravenous ciprofloxacin for three weeks and was discharged from the hospital with oral ciprofloxacin and trimethoprim- sulfamethoxazole for another five months of treatment. The patient was doing well when last seen two months after discontinuation of antimicrobial treatment. In addition, a total of ten cases of typhoid spondylitis/ spondylodiscitis were reviewed.
Keywords : Salmonella, Salmonella Typhi, Typhoid, Spondylodiscitis, Spondylitis, Epidural abscess
