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

Publication ,  Journal Article
Gago, R; Vilá, S; Vélez-Rivera, J; Vilá, LM
Published in: BMJ case reports
January 2018

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.

Duke Scholars

Published In

BMJ case reports

DOI

EISSN

1757-790X

ISSN

1757-790X

Publication Date

January 2018

Volume

2018

Start / End Page

bcr-2017-222474

Related Subject Headings

  • Tomography, X-Ray Computed
  • Systemic Inflammatory Response Syndrome
  • Sacroiliac Joint
  • Postoperative Complications
  • Middle Aged
  • Methylprednisolone
  • Male
  • Magnetic Resonance Imaging
  • Low Back Pain
  • Humans
 

Citation

APA
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ICMJE
MLA
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Gago, R., Vilá, S., Vélez-Rivera, J., & Vilá, L. M. (2018). Severe systemic inflammatory response syndrome immediately after spinal surgery in a patient with axial gout. BMJ Case Reports, 2018, bcr-2017-222474. https://doi.org/10.1136/bcr-2017-222474
Gago, Ricardo, Salvador Vilá, Jonathan Vélez-Rivera, and Luis M. Vilá. “Severe systemic inflammatory response syndrome immediately after spinal surgery in a patient with axial gout.BMJ Case Reports 2018 (January 2018): bcr-2017-222474. https://doi.org/10.1136/bcr-2017-222474.
Gago R, Vilá S, Vélez-Rivera J, Vilá LM. Severe systemic inflammatory response syndrome immediately after spinal surgery in a patient with axial gout. BMJ case reports. 2018 Jan;2018:bcr-2017-222474.
Gago, Ricardo, et al. “Severe systemic inflammatory response syndrome immediately after spinal surgery in a patient with axial gout.BMJ Case Reports, vol. 2018, Jan. 2018, p. bcr-2017-222474. Epmc, doi:10.1136/bcr-2017-222474.
Gago R, Vilá S, Vélez-Rivera J, Vilá LM. Severe systemic inflammatory response syndrome immediately after spinal surgery in a patient with axial gout. BMJ case reports. 2018 Jan;2018:bcr-2017-222474.

Published In

BMJ case reports

DOI

EISSN

1757-790X

ISSN

1757-790X

Publication Date

January 2018

Volume

2018

Start / End Page

bcr-2017-222474

Related Subject Headings

  • Tomography, X-Ray Computed
  • Systemic Inflammatory Response Syndrome
  • Sacroiliac Joint
  • Postoperative Complications
  • Middle Aged
  • Methylprednisolone
  • Male
  • Magnetic Resonance Imaging
  • Low Back Pain
  • Humans