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Disseminated actinomycosis causing incomplete paralysis
  1. Shuzhong Liu1,
  2. Xi Zhou1,
  3. An Song2,
  4. Zhen Huo3,
  5. Yipeng Wang1,
  6. Yong Liu1
  1. 1 Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
  2. 2 Key Laboratory of Endocrinology, Department of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
  3. 3 Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
  1. Correspondence to Professor Yong Liu, Department of Orthopedic Surgery, Peking Union Medical College Hospital, Beijing 100730, China; liuyong_pumch{at}163.com

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In May 2018, a 55-year-old man without underlying disease presented to emergency department with a 2-month history of aggravated cough, chest pain, fever and decreased muscle strength of limbs. The patient denied experiencing any other constitutional symptoms and no history of trauma or surgery during the past years. Physical examination showed coarse breath sounds and dullness to percussion of the right upper lung, and decreased sensation to pinprick and fine touch of bilateral extremities and exhibited a 3/5 strength in the extremities. Fluorodeoxyglucose positron emission tomography/CT scan revealed plenty of empyema of the right upper lung, multiple bone destruction of the adjacent spine, with high suspicion of infection (figure 1A). MRI of spine showed multiple bone destruction of the spine with significant spinal stenosis. Combined with anti-infective therapy, thoracocentesis was performed after multidisciplinary consultation. Bacteriological examination …

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Footnotes

  • Contributors SL wrote the first draft of the manuscript and submitted the manuscript. XZ, AS and ZH were in charge of the patient and collected the data. SL and YL did the follow-up of the patient. YW and YL critically revised the manuscript and contributed equally to this paper. All authors approved the final version.

  • Funding This study was funded by Peking Union Medical College Graduate Student Innovation Fund (Project No 2018-1002-02-08) and National Natural Science Foundation of China, http://dx.doi.org/10.13039/501100001809 (Project No 81871746).

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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