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Pyogenic spondylitis caused by Streptococcus dysgalactiae subspecies equisimilis in a patient with nasopharyngeal cancer
Institution:2. Department of Head and Neck Surgery, Miyagi Cancer Center, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi, Japan;3. Department of Head and Neck Oncology Division, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan;1. Department of Pharmacy, Kitasato University Hospital, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan;2. Pharmacy Practice and Science I, Research and Education Center for Clinical Pharmacy, Kitasato University School of Pharmacy, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan;3. Department of Infection Control and Infectious Diseases, Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan;4. Department of Pharmacy, Tokyo Medical And Dental University Hospita, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan;5. Laboratory of Clinical Pharmacokinetics, Research and Education Center for Clinical Pharmacy, Kitasato University School of Pharmacy, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan;6. Department of Colorectal Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan;7. First Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan;8. Departments of Pharmacology and Anesthesiology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan;9. Infection Control Research Center, Kitasato Institute for Life Sciences, Kitasato University, 5-9-1 Shirogane, Minato-ku, Tokyo, 108-8641, Japan;1. Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan;2. Department of Gastroenterology, Mitoyo General Hospital, Kannonji, Japan;3. Department of Gastroenterology, Asahi General Hospital, Asahi, Japan;4. Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan;5. Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan;6. Department of Internal Medicine, Division of Gastroenterology and Hepatology, Nippon Medical School, Tokyo, Japan;7. Department of Hepatology, Saiseikai Niigata Hospital, Niigata, Japan;8. Department of Internal Medicine, Division of Gastroenterology, Kikkoman General Hospital, Noda, Japan;9. Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan;10. Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan;11. Department of Gastroenterology and Core Research Facilities for Basic Science, The Jikei University School of Medicine, Tokyo, Japan;12. Gastroenterology Center, Yokohama City University Medical Center, Yokohama, Japan;13. Department of Internal Medicine, Division of Gastroenterology and Hepatology, Shinmatusdo Central General Hospital, Matsudo, Japan;14. Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita, Japan;15. Department of Nursing, Gifu Kyoritsu University, Ogaki, Japan;p. Department of Epidemiology, Infectious Disease Control, and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan;1. Department of Infectious Diseases, Kagawa Prefectural Central Hospital 1-2-1 Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan;2. Departments of General and Gastroenterological Surgery, Kagawa Prefectural Central Hospital 1-2-1 Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan;1. Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan;2. Division of Infectious Diseases, Jichi Medical University Hospital, Tochigi, Japan;3. Department of Clinical Laboratory, Jichi Medical University Hospital, Tochigi, Japan;4. Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Japan;1. Department of Laboratory Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China;2. Department of Respiratory Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China;1. The University of Tokyo Hospital, Department of Infectious Diseases, Tokyo, Japan;2. Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
Abstract:In the treatment of head and neck cancer, radiation therapy is an effective modality and is often used in routine clinical practice. Although rare, pyogenic spondylitis has been reported as a complication of radiation therapy. Here, we report a case of nasopharyngeal carcinoma resulting in pyogenic spondylitis from a catheter-related bloodstream infection after chemoradiotherapy. The initial symptoms were fever and posterior cervical pain. Streptococcus dysgalactiae subspecies equisimilis was detected in blood cultures. Magnetic resonance imaging showed abnormal enhancement of the C6 and C7 vertebrae and an anterior epidural abscess. The infection was successfully treated with antibacterial therapy.
Keywords:Head and neck cancer  Catheter-related bloodstream infection  Pyogenic spondylitis
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