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Papers of the Week

2022 Dec

Gan To Kagaku Ryoho



[A Case of Intractable Pyogenic Spondylitis Due to Suture Failure and MRSA Infection Secondary to Surgery for Ascending Colon Cancer].


Yokomatsu H, Shibutani M, Katsuragi K, Xiang Z, Fukui Y, Nagai J, Nakai K
Gan To Kagaku Ryoho. 2022 Dec; 49(13):1585-1587.
PMID: 36733143.


A 79-year-old man diagnosed with ascending colon cancer underwent laparoscopic right hemicolectomy(Stage Ⅱ). Postoperatively, suture failure occurred on Day 5 and was alleviated with conservative therapy. However, on Day 23, he was diagnosed with MRSA-induced sepsis with a body temperature of 39 °C. After administration of vancomycin, his general conditions stabilized, although intermittent low-grade fever and a high C-reactive protein(CRP)level persisted. Although the source of the infection could not be easily identified, he was diagnosed with suppurative spondylitis after lumbar MRI examination on Day 43. The CRP level was normalized with long-term administration of antibiotics and the symptoms were gradually improved with rehabilitation. The patient was discharged after approximately 4 months and could walk without assistance 8 months postoperatively. In this case, purulent spondylitis may have occurred via hematogenous infection due to the suture failure after surgery for ascending colon cancer. Purulent spondylitis is a relatively rare disease. However, it may lead to the patient requiring long-term treatment and cause serious sequelae. Therefore, it is important to keep this disease in mind when treating patients with postoperative fever of unknown origin or aggravating lower back pain.