Severe systemic inflammatory response syndrome immediately after spinal surgery in a patient with axial gout.

Journal Article (Journal Article)

We report a 55-year-old man with gouty arthritis who developed a 3-month history of low back pain, gradual lower extremities weakness and urinary incontinence. Lumbar MRI showed an exophytic lesion at L3-L4. Immediately after spinal decompression surgery, he developed fever, disorientation, polyarthritis, acute kidney injury and leucocytosis. He was treated with multiple antimicrobial agents for presumed spinal abscess but did not improve. Multiple body site cultures were negative. Aspiration of the sacroiliac joint revealed the presence of monosodium uric acid crystals. A diagnosis of acute gout was done, and he was treated with high-dose intravenous methylprednisolone and colchicine. Within 48 hours, he had a remarkable clinical improvement. At discharge, neurological and laboratory abnormalities had resolved. Awareness of risk factors for axial gout and a high degree of suspicion are important to establish a prompt diagnosis and treatment to prevent severe complications as seen in this case.

Full Text

Duke Authors

Cited Authors

  • Gago, R; Vilá, S; Vélez-Rivera, J; Vilá, LM

Published Date

  • January 24, 2018

Published In

Volume / Issue

  • 2018 /

PubMed ID

  • 29367221

Pubmed Central ID

  • PMC5786998

Electronic International Standard Serial Number (EISSN)

  • 1757-790X

Digital Object Identifier (DOI)

  • 10.1136/bcr-2017-222474


  • eng

Conference Location

  • England