SURGICAL TREATMENT OF TUBERCULOUS SPONDYLITIS IN A PATIENT, LIVING WITH HIV INFECTION, ON A BACKGROUND OF DEEP IMMUNOSUPPRESSION
https://doi.org/10.22328/2077-9828-2017-9-3-65-72
- Р Р‡.МессенРТвЂВВВВВВВВжер
- РћРТвЂВВВВВВВВнокласснРСвЂВВВВВВВВРєРСвЂВВВВВВВВ
- LiveJournal
- Telegram
- ВКонтакте
- РЎРєРѕРїРСвЂВВВВВВВВровать ссылку
Full Text:
Abstract
Purpose: аnalysis of typical case of complicated course of tuberculous spondylitis in a female patient living with deep immunosuppression. Materials and methods: the Examination and treatment of the patient was carried out in accordance with national clinical guidelines for TB using standardized scales and by the presence of postoperative complications. Conclusion: late referral of the patient for medical care (after 7 months from disease onset), lasting, conservative (6 months) treatment without regard to sensitivity to anti-TB drugs, ineffective surgical on the treatment of tuberculous spondylitis has led to a complicated course of tuberculosis spondylitis. The error in tactics of treatment has led to the need for further multi-stage surgical treatment.
About the Authors
S. V. BurlakovRussian Federation
A. A. Vishnevskiy
Russian Federation
References
1. Sheremet A.V., Grishko A.N., Tomashevskii A.V. i dr. Osnovnye organizatsionnye meropriyatiya po optimizatsii lecheniya tuberkuleza v territoriyakh Severo-Zapada Rossii. V kn.: Aktual'nye voprosy lecheniya tuberkuleza razlichnykh lokalizatsii: trudy Vseros. nauch.-prakt. konf. SPb., 2008. S. 298-301. [Sheremet A.V., Grishko A.N., Tomashevsky A.V. et al. The basic organizational measures for optimization of tuberculosis treatment in areas of the North-West of Russia. In: Current issues in treatment of tuberculosis of different localizations: proceedings of all-Russia: Proceedigs of the Conference Title. Saint-Petersburg, 2008, pp. 298-301 (In Russ.)].
2. Vishnevskii A.A. Gnoino-vospalitel'nye zabolevaniya pozvonochnika i spinnogo mozga. V kn.: Zabolevaniya pozvonochnika i spinnogo mozga: kliniko-luchevaya diagnostika i lechenie / Pod red. V.V.Shchedrenka. SPb.: LOIRO, 2014. S. 340-386. [Vishnevsky A.A. Purulent-inflammatory diseases of the spine and spinal cord. In: Diseases of the spine and spinal cord: a clinical and radiological diagnosis and treatment. Ed. V.V.Shchadranok. Saint-Petersburg: LOIRO, 2014, pp. 340-386 (In Russ.)].
3. Burlakov S.V., Oleinik V.V., Vishnevskii A.A. Vliyanie dlitel'nosti zabolevaniya tuberkuleznym spondilitom na razvitie oslozhnenii // Travmatologiya i ortopediya Rossii. 2013. № 1. S. 61-66. [Burlakov S.V., Oleynik V.V., Vishnevsky A.A. Effect of duration of disease tuberculous spondylitis in the development of complications. Traumatology and Orthopedics Russia, 2013, No. 1, pp. 61-66 (In Russ.)].
4. Lavrov V.N. Novye tekhnologii v khirurgicheskom lechenii tuberkuleznogo spondilita // Problemy tuberkuleza. 2002. № 2. S. 20-24. [Lavrov V.N. New technologies in surgical treatment of tuberculous spondylitis. Problems of Tuberculosis, 2002, No. 2, pp. 20-24 (In Russ.)].
5. Peretsmanas E.O. Prichiny poyavleniya invalidiziruyushchikh form tuberkuleznogo spondilita // Problemy tuberkuleza. 2002. № 8. S. 6-7. [Peretsmanas E.O. The causes of disabling forms of tuberculous spondylitis. Problems of Tuberculosis, 2002, No. 8, pp. 6-7 (In Russ.)].
6. Mirzoev S.O., Sulaimanov I.I., Yusupov E.Yu. i dr. Radikal'noe khirurgicheskoe lechenie oslozhnennykh form tuberkuleza poyasnichnogo otdela pozvonochnika. V kn.: Aktual'nye voprosy lecheniya tuberkuleza razlichnykh lokalizatsii: trudy Vseros. nauch.-prakt. konf. SPb., 2008. S. 153. [Mirzoev S.O., Sulaimanov I.I., Yusupov E.Yu. et al. Radical surgical treatment of complicated forms of tuberculosis of the lumbar spine. In: Current issues in treatment of tuberculosis of different localizations: Proceedigs of the Conference Title. Saint-Petersburg, 2008, pp. 153 (In Russ.)].
7. Yablonskii P.K., Mushkin A.Yu., Belilovskii E.M. i dr. Vnelegochnyi tuberkulez v Rossiiskoi Federatsii. V kn.: Tuberkulez v Rossiiskoi federatsii v 2011 g.: analiticheskii obzor. M.: Triada, 2013. S. 111-114. [Yablonsky P.K., Mushkin A.Yu., Belilovsky E.M. et al. Extrapulmonary tuberculosis in the Russian Federation. In: Tuberculosis in the Russian Federation in 2011: an analytical review. Moscow: Triada, 2013, pp. 111-114 (In Russ.)].
8. Ftiziatriya. Natsional'nye klinicheskie rekomendatsii / Pod red. P.K.Yablonskogo. M.: GEOTAR-Media, 2015. 240 s. [Phthisiology. National clinical guidelines. Ed. P.K.Yablonsky. Moscow: GEOTAR-Media, 2015, 240 p. (In Russ.)].
9. Reshetneva E.V., Vishnevskii A.A. Kliniko-immunologicheskie osobennosti tuberkuleznogo spondilita u VICh-infitsirovannykh patsientov // VICh-infektsiya i immunosupressii. 2014. T. 6, № 1. S. 46-51. [Reshetneva E.V., Vishnevsky A.A. Clinical and immunological features of tuberculous spondylitis in HIV-infected patients. HIV Infection and Immunosuppressive Disorders, 2014, Vol. 6, No. 1, pp. 46-51 (In Russ.)].
10. Sharma S.K., Mohan A. Extrapulmonary tuberculosis. Indian J. of Medical Research, 2004, Vol. 120, pp. 316-353.
11. Anley C.M., Brandt A.D., Dunn R. Magnetic resonance imaging findings in spinal tuberculosis: Comparison of HIV positive and negative patients. Indian J. of orthopaedics, 2012, Vol. 46, No. 2, pp. 186.
12. Panteleev A.M., Savina T.A., Suprun T.Yu. Vnelegochnyi tuberkulez u VICh-infitsirovannykh // Problemy tuberkuleza. 2007. № 2. S. 16-19. [Panteleev A.M., Savina T.A., Suprun T.Yu. Extrapulmonary tuberculosis in HIV infected persons. Problems of Tuberculosis, 2007, No. 2, pp. 16-19 (In Russ.)].
13. Kornilova Z.Kh., Lukonina I.V., Alekseeva L.P. Tuberkulez v sochetanii s VICh-infektsiei // Tuberkulez i bolezni legkikh. 2010. № 3. S. 3-9. [Kornilova Z.Kh., Lukonina I.V., Alekseeva L.P. Tuberculosis in combination with HIV infection. Tuberculosis and Lung Disease, 2010, No. 3, pp. 3-9 (In Russ.)].
14. Frolova O.P., Kravchenko A.V., Yurin O.G. Opredelenie stadii VICh-infektsii u bol'nykh tuberkulezom // Infektsionnye bolezni. 2009. № 4. S. 70-74. [Frolova O.P., Kravchenko A.V., Yurin O.G. Determination of the stage of HIV infection in patients with tuberculosis. Infectious Diseases, 2009, No. 4, pp. 70-74 (In Russ.)].
15. Garbuz A.E., Serdobintsev M.S., Guseva V.N. Sovremennaya vosstanovitel'naya khirurgiya tuberkuleza pozvonochnika i sustavov // Problemy tuberkuleza. 2002. № 4. C. 27-31. [Garbuz A.E., Serdobintsev M.S., Guseva V.N. Modern reconstructive surgery of tuberculosis of the spine and joints. Problems of Tuberculosis, 2002, No. 4, pp. 27-31 (In Russ.)].
16. Basankin I.V., Enin M.A., Naberezhnykh A.E. Khirurgicheskoe lechenie spondilitov s ispol'zovaniem titanovoi setki i stabilizatsii. V kn.: Aktual'nye voprosy lecheniya tuberkuleza razlichnykh lokalizatsii: trudy Vseros. nauch.-prakt. konf. SPb., 2008. S. 102-104. [Basankin I.V., Enin M.A., Naberezhnyth A.E. Surgical treatment of spondylitis by use of a titanium mesh and stabilization. In: Current issues in treatment of tuberculosis of different localizations: Proceedigs of the Conference Title. Saint-Petersburg, 2008, pp. 102-104 (In Russ.)].
17. Goncharov M.Yu., Levchik E.Yu. Khirurgicheskoe lechenie nespetsificheskikh osteomielitov pozvonochnika u VICh-infitsirovannykh // VICh-infektsiya i immunosupressii. SPb., 2012. T. 4, № 3. S. 62-65. [Goncharov M.Yu., Levchik E.Yu. Surgical treatment of nonspecific osteomyelitis of the spine in HIV infected. HIV Iinfection and Immunosuppressive Disordes, 2012, Vol. 4, No. 3, pp. 62-65 (In Russ.)].
18. Siewe J., Oppermann J., Eysel R., Zarghooni K., Sobottke R. Diagnosis and treatment of spondylodiscitis in HIV-positive patients. Acta Orthopaedica Belgica, 2013, Vol. 79, No. 5, pp. 475-482.
19. Reshetneva E.V. Tuberkulez u bol'nykh VICh-infektsiei i effektivnost' ego khirurgicheskogo lecheniya. Avtoref. dis. … kand. med. nauk. SPb., 2015. [Reshetneva E.V. Tuberculosis in patients with HIV infection and the effectiveness of its surgical treatment. Extended abstract of candidate’s thesis. Saint-Petersburg, 2015 (In Russ.)].
20. Nechaeva O.B., Eismant N.V. Khirurgicheskaya pomoshch' bol'nym tuberkulezom pri sochetanii s VICh-infektsiei // Tuberkulez i bolezni legkikh. 2012. № 3. S. 24-31. [Nechayeva O.B., Eismant N.V. Surgical care of patients with tuberculosis in combination with HIV infection. Tuberculosis and Lung Disease, 2012, No. 3, pp. 24-31 (In Russ.)].
21. Buliskeriya T.N. Osobennosti vedeniya khirurgicheskikh bol'nykh s soputstvuyushchei VICh-infektsiei. Avtoref. dis. … kand. med. nauk. M., 2004. [Buliskeria T.N. Features of management of surgical patients with concomitant HIV infection. Extended abstract of candidate’s thesis. Moscow, 2004 (In Russ.)].
22. Burlakov S.V., Vishnevskii A.A., Oleinik V.V. Analiz rannikh i pozdnikh posleoperatsionnykh oslozhnenii na osnove izucheniya perioperatsionnykh faktorov riska i komorbidnosti bol'nykh tuberkuleznym spondilitom. V kn.: Riski i oslozhneniya v sovremennoi travmatologii i ortopedii. Materialy Vseros. nauch.-prakt. konf. Omsk: Omskblankizdat, 2015. C. 125-126. [Burlakov S.V., Vishnevsky A.A., Oliynyk V.V. Analysis of early and late postoperative complications based on the study of perioperative risk factors and comorbidities of patients with tuberculous spondylitis. In: Risks and complications in modern traumatology and orthopedics. Proceedigs of the Conference Title. Omsk: Omskblankizdat, 2015, pp. 125-126 (In Russ.)].
23. Vishnevskii A.A., Burlakov S.V., Oleinik V.V. Faktory, vyzyvayushchie oslozhneniya pri khirurgicheskom lechenii tuberkuleznogo spondili- ta // Dal'nevostochnyi meditsinskii zhurnal. 2013. № 1. S. 34-38. [Vishnevsky A.A., Burlakov S.V., Oleynik V.V. Factors causing complications in the surgical treatment of tuberculous spondylitis. Far Eastern Medical J., 2013, No. 1, pp. 34-38 (In Russ.)]
Review
For citations:
Burlakov S.V., Vishnevskiy A.A. SURGICAL TREATMENT OF TUBERCULOUS SPONDYLITIS IN A PATIENT, LIVING WITH HIV INFECTION, ON A BACKGROUND OF DEEP IMMUNOSUPPRESSION. HIV Infection and Immunosuppressive Disorders. 2017;9(3):65-72. (In Russ.) https://doi.org/10.22328/2077-9828-2017-9-3-65-72