Pedro Pons’ sign of brucellar spondylitis

Wu, Na; Zhang, Yi; Yu, Yehua

doi:10.1590/0037-8682-0561-2019

Cited by 2 publications

(2 citation statements)

References 2 publications

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“…They described it as a destructive appearance at the anterosuperior aspect of the vertebral body, with associated osteosclerosis and osteophyte formation. These, in combination, are characteristic findings of brucellar spondylitis [ 6 , 22 , 24 ]. This was evident on imaging of our patient as well ( Fig.…”

Section: Discussionmentioning

confidence: 99%

Spinal Brucellosis: A Case Report and Review of the Literature

Rizkalla

Alhreish

Syed

2021

JOCR

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Introduction: The most common location of infection of brucellosis is the musculoskeletal system. It is estimated that the spine is involved in 2–54% of brucellosis infections, with the lumbar spine most commonly affected. We report an uncommon case of brucellar spondylodiscitis, in addition to the pathology, common presentation, and management of spinal brucellosis through additional literature review. Case Report: A 65-year-old Hispanic male presented to an orthopedic spine surgeon with signs and symptoms concerning for metastatic disease to the spine. Investigation revealed that the patient had the rare diagnosis of brucellar spondylodiscitis. This only became apparent after detailed questioning of the patient’s history revealed his employment within a Mexican meat slaughterhouse and a regular consumer of unpasteurized Mexican cheeses. Conclusion: Although uncommon, brucellosis spondylodiscitis should remain as a differential diagnosis in any patient who presents with back pain and fever. Detailed history taking and thorough physical examination remain vital in the work-up of brucellar spondylodiscitis. Understanding the pathology, radiographic findings, and necessary work-up are essential to properly treat this infection. Keywords: Spine, Brucella, spinal brucellosis, infection, spondylodiscitis, discitis, abscess.

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Section: Discussionmentioning

confidence: 99%

Spinal Brucellosis: A Case Report and Review of the Literature

Rizkalla

Alhreish

Syed

2021

JOCR

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“…Given that tuberculosis was not bacteriologically confirmed and that the patient's symptoms worsened during a more than two‐month treatment trial with tuberculous chemotherapy, the odds of tuberculosis fell. 11 Yet brucellosis was less likely because the MRI spine showed no signs of spondylodiscitis or anterosuperior destruction of the vertebral body (Pedro‐Pons' Sign), which are radiological features associated with brucellosis, 12 and since the serology (IgM and IgG) was both negative. Further investigations were performed to rule out the possibility of a metastatic tumor from the breast, gastrointestinal tract, or prostate to the lung and spine.…”

Section: Differential Diagnoses Investigations and Treatmentmentioning

confidence: 99%

Diffuse type gastric adenocarcinoma with atypical presentation: A case report

Edwin,

Mbishi,

Zerd

et al. 2024

Clinical Case Reports

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Key Clinical MessageGastric adenocarcinoma can present uncommonly. This emphasizes the need for intensified vigilance in the absence of typical gastrointestinal symptoms, particularly in areas where infectious diseases are common.AbstractGastric adenocarcinoma, a common advanced‐age global malignancy is typically associated with abdominal symptoms. However, atypical presentations such as back pain and respiratory distress particularly in younger patients represent diagnostic challenges. We present a case of a late‐30s male who presented initially with back pain, shortness of breath, and constitutional symptoms. A diagnosis of tuberculosis was established presumptively with immediate initiation of treatment. Later on, he presented with abdominal pain and intractable vomiting. Oesophagoduodenoscopy (OGD), tissue histology, and immunohistochemistry confirmed a diffuse type gastric adenocarcinoma. He died as a result of complications from an advanced disease. This particular instance emphasizes the importance of maintaining a high index of skepticism even in atypical presentations, as well as the significance of prompt OGD alongside potential genetic testing if any. Gastric adenocarcinoma should be contemplated by clinicians in a variety of clinical scenarios, especially when handling younger patients from settings with limited resources to facilitate timely diagnosis and effective treatment.

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Pedro Pons’ sign of brucellar spondylitis

Abstract: Images in Infectious Diseases FIGURE 1: Computed tomography scan showing apparent destruction at the anterior superior corner of the L4 vertebra (Pedro Pons' sign) accompanied by prominent osteosclerosis and osteophytes resembling a parrot's beak.

Cited by 2 publications

References 2 publications

Spinal Brucellosis: A Case Report and Review of the Literature

Spinal Brucellosis: A Case Report and Review of the Literature

Diffuse type gastric adenocarcinoma with atypical presentation: A case report

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