Pyogenic Spondylitis due to Central Venous Catheter Infection after Gastric Cancer Surgery—A Case Report—

Abstract

A 79-year-old man was diagnosed with advanced gastric cancer and underwent total gastrectomy with D2 lymphadenectomy and Roux-en-Y reconstruction. Pancreatic fistula on postoperative day 5 and duodenal stump leakage on postoperative day 9 occurred. These complications were improved with conservative treatment, however, septic shock due to catheter infection occurred on postoperative day 25. The central venous catheter (CVC) was immediately removed, and antibiotic treatment was started. Low back pain appeared 32 days after the surgery and gradually worsened. Lumber MRI on 49 days after the surgery led to a diagnosis of pyogenic spondylitis. He was treated with conservative therapy with antibiotics and rest and was discharged 96 days after the surgery without any neurological sequelae. There are some patients who require CVC during the perioperative period of gastric cancer. If low back pain appears after CVC infection, early diagnosis and intervention should be performed with the complication of pyogenic spondylitis in mind. Further studies about perioperative management without CVC or preventing clinical conditions that require long-term treatment with CVC are necessary.