Necrotizing fasciitis caused by Haemophilus influenzae type E in a 17-year-old girl with systemic lupus erythematosus.

摘要

A 77-year-old Caucasian woman, who did not smoke or drink alcohol, presented with severe back pain following a fall. Spine radiograph demonstrated wedge-compression fractures of Til and T12 (Fig. 1A). Magnetic resonance imaging showed the fractures and no neurologic compromise or evidence of bony malignancy. Dual-energy x-ray absorptiometry (DXA) scanning revealed a T-score of -4.2 at her spine and —1.3 at her hip. In addition to her background risk factors for osteoporosis (female, postmenopausal, low body weight, resident in Ireland), her 25-OH vitamin D levels were noted to be low at 43 nmol/L (normal: >80 nmol/L). Routine laboratory tests, including inflammatory markers, glucose, thyroid function, and tissue transglutaminase antibodies, were within normal limits. She underwent vertebroplasty to help reduce pain and prevent further vertebral collapse (Fig. IB). She was also treated with calcium, vitamin D, and bisphosphonate therapy and advised regarding weight-bearing exercise. However, she had lost significant height, reported daily back pain, and struggled to maintain independent living.