RESUMEN
Introduction: Infective spondylodiscitis, resulting from bacterial or fungal infections in intervertebral discs and adjacent vertebral bodies, poses diagnostic dilemmas due to its rare occurrence and subtle symptomatology. This report underscores the importance of a multidisciplinary approach in navigating the complexities of infective spondylodiscitis, particularly in patients with concomitant chronic kidney disease (CKD). Case Report: A 53-year-old male, 5 years into renal dialysis for CKD, presented with a 3-month history of severe neck pain radiating to both arms, accompanied by tingling sensations. Neurological evaluation revealed weakness and gait imbalance. Laboratory findings indicated elevated serum creatinine, erythrocyte sedimentation rate, and C-reactive protein. Imaging confirmed vertebral destruction, necessitating a staged treatment plan involving surgical intervention, corpectomy, mesh placement, and fusion. Intraoperative cultures yielded negative results, prompting continued broad-spectrum antibiotic therapy intravenously for 2 weeks, followed by an additional 4 weeks orally. Discussion: The case discussion explores common risk factors for infective spondylodiscitis, emphasizing the need for a comprehensive diagnostic approach in patients with immunocompromised conditions, such as CKD. Despite negative cultures, the patient's favorable clinical response and neurological recovery underscore the intricate nature of infectious processes, especially in individuals with underlying health concerns. Conclusion: This case report serves as a poignant reminder of the challenges associated with infective spondylodiscitis in CKD patients on hemodialysis. The classic triad of pain, fever, and neurological deficits should trigger a thorough diagnostic investigation, leveraging advanced imaging techniques for accurate diagnosis. A multidisciplinary approach and regular follow-ups are essential in managing such complex cases, contributing to improved patient outcomes and overall healthcare quality.
RESUMEN
Introduction: Hodgkin's lymphoma has been observed to rarely manifest with extra nodal involvement, typically occurring in the latter stages of the disease. However, spinal cord compression may also be regarded as a rare predominant symptom to occur in this context. In this case report, we discuss the clinical details of a 37-year-old patient who exhibited upper motor neuron symptoms and gait imbalance. The patient's medical history includes a confirmed diagnosis of Hodgkin's lymphoma. Case Report: A 37-year-old male patient reported to the outpatient department with bilateral upper limb weakness and gait impairment. The individual presented as a documented case of previous Hodgkin's lymphoma, with magnetic resonance imaging (MRI) revealing the presence of anterior epidural soft tissue mass at the C6-D1 vertebral levels. This pathological condition resulted in the compression and posterior displacement of the spinal cord. The patient was scheduled to have an emergency decompression surgery involving a C7 corpectomy and C6-D1 fusion procedure utilizing a mesh cage and plate. Conclusion: The conventional approach of utilizing only Chemotherapy and Radiotherapy for patients with Hodgkin's lymphoma should be reevaluated, as it is imperative to address neurological symptoms resulting from spinal cord compression which also can indicate the stage of the disease. Incorporating surgical interventions into the treatment plan can contribute to the restoration of function in affected patients.