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@ARTICLE{Mirbagheri:179321,
      author       = {A. Mirbagheri and N. Etminan and S. Schölch$^*$ and C.
                      Maier$^*$ and J. Perrin and F. Enders},
      title        = {{L}umbar spondylodiscitis-mimicking cholecystitis - a case
                      report and review of literature.},
      journal      = {Journal of neurological surgery / A},
      volume       = {84},
      number       = {1},
      issn         = {2193-6315},
      address      = {Stuttgart},
      publisher    = {Thieme},
      reportid     = {DKFZ-2022-00589},
      pages        = {95-102},
      year         = {2023},
      note         = {2023 Jan;84(1):95-102},
      abstract     = {Lower back pain is a frequent cause of Emergency Department
                      visits and one of the leading causes of the disease burden
                      worldwide. The purpose of this case report and literature
                      review was to discuss atypical abdominal entities mimicking
                      spinal diseases typically presenting with lower back pain.A
                      79-year-old male presented with lower back pain and urinary
                      incontinence after receiving a non-image-guided lumbar
                      infiltration treatment four weeks prior to admission. The
                      MRI highlighted multi-segmental hyperintensities in the
                      intervertebral disc spaces of the lumbar spine indicative
                      for spondylodiscitis. Antibiotic treatment over a week did
                      not lead to significant clinical improvement. Blood
                      cultures, cardiologic, otorhinolaryngologic and dental
                      examinations turned out negative for a focus of infection. A
                      CT-guided biopsy was indicated after discontinuation of
                      antibiotic treatment for less than 24 hours. Rapid clinical
                      deterioration with concomitant onset of abdominal pain
                      resulted in the diagnosis of cholecystitis, which required
                      cholecystectomy. We performed a systematic literature review
                      using the Pubmed database for the key words
                      'spondylodiscitis', 'spine', 'abdominal' and
                      'cholecystitis', to identify abdominal diseases that mimic
                      spine pathologies and spinal diseases that mimic abdominal
                      pathologies.No other report in English literature of
                      cholecystitis associated with initial onset of lower back
                      pain was identified. Eighteen reports referred to abdominal
                      conditions that mimic spinal diseases among them a patient
                      with cyclic lumbar back pain who received a lumbar spinal
                      fusion who, after persisting symptoms led to further
                      diagnostic procedures, was ultimately diagnosed with
                      endometriosis. Spinal symptoms included paraplegia and
                      urinary incontinence as results of acute aortic pathologies.
                      Eleven reports presented spinal pain mimicking abdominal
                      conditions including abdominal pain and diarrhea as well as
                      have had surgical procedures such as an appendectomy before
                      the spinal condition was discovered.Clinical symptoms of the
                      spine such as lower back pain can be unspecific and lead to
                      false conclusions in the presence of concomitant pathologies
                      in MRI. Only clinical deterioration in our case patient
                      prompted correction of the diagnosis on day seven. Initial
                      workup for alternative common infectious foci such as lung
                      and urinary tract was performed, but further abdominal
                      workup despite the absence of abdominal symptoms may have
                      led to an earlier diagnosis. Our literature review found
                      several cases of misdiagnosed spinal and abdominal
                      conditions, respectively. Some had undergone unnecessary
                      invasive surgical procedures before the right diagnosis was
                      concluded. Because of the high incidence of symptoms such as
                      lumbar back pain as well as abdominal pain, considering
                      optimal patient care as well as economic aspects it would be
                      essential to conduct an interdisciplinary clinical
                      management to avoid errors in the early stage of
                      diagnostics.},
      cin          = {A430},
      ddc          = {610},
      cid          = {I:(DE-He78)A430-20160331},
      pnm          = {311 - Zellbiologie und Tumorbiologie (POF4-311)},
      pid          = {G:(DE-HGF)POF4-311},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:35354214},
      doi          = {10.1055/a-1811-7393},
      url          = {https://inrepo02.dkfz.de/record/179321},
}