Veillonella discitis. A case report.
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Adult↗
Biomedical subjects
Jehan Lecocq
Publications and source records attributed to Jehan Lecocq.
Sciatica, disk herniation, and neuroborreliosis. A report of four cases.
We report four cases of sciatica in patients with same-level disk herniation confirmed by computed tomography and a final diagnosis of acute radiculitis caused by Borrelia burgdorferi, with a favorable response to ceftriaxone therapy. The neurological manifestations of Lyme disease are protean, and a potential contribution of concomitant disk disease to sciatica can lead to diagnostic wanderings. Disk lesions and infectious conditions that can cause sciatica are discussed. Whether a favorable response to antibiotic therapy should be taken as proof of B. burgdorferi radiculitis deserves discussion. In practice, in a patient with clinical manifestations suggesting disk-related nerve root pain and residing or having traveled to an endemic area, B. burgdorferi infection should be looked for, as both etiologies can coexist.
Acute Disease↗
[A rare cause of constipation: neurinoma of the fourth lumbar nerve. Case report and review of the literature ].
Constipation is a symptom not to be neglected, especially if the complaint is recent. We report a case where this symptom was the only clinical manifestation of a voluminous retroperitoneal tumor. The tumor was found to be a neurilemmoma of the fourth right lumbar roots, confirmed at pathological examination. Manifestations of extradural neurinomas generally result from compression of neighboring structures. The best preoperative diagnosis approach is magnetic resonance imaging but histology is required for confirmation. The close relations the tumor mass maintains with the unaffected nerve fibers makes resection difficult without postoperative functional consequences. Surgeons discuss the relevance of partial excision in order to preserve the nerve root in case of a benign slow-growing tumor. There does however appear to be a significant recovery of muscle strength even in case of total resection.
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