ABSTRACT
Typhoid fever still steadily occurrs, although its incidence decreased in Korea. Even though the clinical manifestations of typhoid fever are varied, there has been no reported case complicated with meningitis, cervical spondylitis and epidural abscess simultaneously. We experienced a case of typhoid fever in an immunocompetent patient complicated with meningitis, cervical spondylitis and cervical epidural abscess. A 55-year old woman was admitted because of fever and neck pain. The finding of her lumbar puncture was compatable with bacterial meningitis, and Salmonella enterica Typhi was found in blood cultures. Despite of medical treatment, neck pain, radiating to upper extremities, was aggravated. Cervical MRI revealed an anterior epidural abscess with spondylitis and discitis at the level of the 5th and 6th cervical vertebral bodies. Removal of epidural abscess and laminectomy were performed for cervical spinal cord compression. Ciprofloxacin was intravenously given for up to one month and was then switched to oral formula. She was cured without neurologic sequelae and has had no relapse for 1 year follow-up.
Subject(s)
Female , Humans , Middle Aged , Ciprofloxacin , Discitis , Epidural Abscess , Fever , Follow-Up Studies , Incidence , Korea , Laminectomy , Magnetic Resonance Imaging , Meningitis , Meningitis, Bacterial , Neck Pain , Recurrence , Salmonella enterica , Salmonella typhi , Spinal Cord Compression , Spinal Puncture , Spondylitis , Typhoid Fever , Upper ExtremityABSTRACT
Typhoid fever still steadily occurrs, although its incidence decreased in Korea. Even though the clinical manifestations of typhoid fever are varied, there has been no reported case complicated with meningitis, cervical spondylitis and epidural abscess simultaneously. We experienced a case of typhoid fever in an immunocompetent patient complicated with meningitis, cervical spondylitis and cervical epidural abscess. A 55-year old woman was admitted because of fever and neck pain. The finding of her lumbar puncture was compatable with bacterial meningitis, and Salmonella enterica Typhi was found in blood cultures. Despite of medical treatment, neck pain, radiating to upper extremities, was aggravated. Cervical MRI revealed an anterior epidural abscess with spondylitis and discitis at the level of the 5th and 6th cervical vertebral bodies. Removal of epidural abscess and laminectomy were performed for cervical spinal cord compression. Ciprofloxacin was intravenously given for up to one month and was then switched to oral formula. She was cured without neurologic sequelae and has had no relapse for 1 year follow-up.
Subject(s)
Female , Humans , Middle Aged , Ciprofloxacin , Discitis , Epidural Abscess , Fever , Follow-Up Studies , Incidence , Korea , Laminectomy , Magnetic Resonance Imaging , Meningitis , Meningitis, Bacterial , Neck Pain , Recurrence , Salmonella enterica , Salmonella typhi , Spinal Cord Compression , Spinal Puncture , Spondylitis , Typhoid Fever , Upper ExtremityABSTRACT
Accessory renal artery (ARA) is a kind of developmental anomaly in renal artery. It is important in respect to clinical medicine, for example primary hypertension, renovascular disease, inferior vena caval obstruction, ureteral obstruction, occurrence of other vascular anomalies such as accessory renal veins, surgical importance and renal transplantation. However, up to few research of ARA was reported in dissection of cadavers. In our dissecting theater, 12 accessory renal arteries for 10 cadavers were found during dissection the 22 cadavers from 1995 to 1996. 1. Two cases were bilateral and 8 cases were unilateral accessory renal arteries. 2. Seven cases were left and 5 cases were right accessory renal arteries. 3. Two cases originated at the abdominal aorta between celiac trunk and superior mesenteric artery, 7 cases originated between superior mesenteric artery and inferior mesenteric artery, and 3 cases originated below inferior mesenteric artery. 4. Seven cases have no branches during their courses, 4 cases have 3 branches, and a case has 2 branches. 5. Seven cases entered into renal parenchyma through renal hilum, 5 cases entered into apical and arterosuperior segments, and 6 cases entered into inferior segment.