Infection--an underappreciated cause of bone pain in multiple myeloma.
Bone pain, especially back pain, is a common presenting feature of myeloma patients. We report three multiple myeloma patients with exacerbations of back pain and referred shoulder pain resulting from vertebral infections. Two patients were treated with surgery, and one patient had computerized tomography-guided percutaneous needle aspiration for diagnostic purposes. All three patients received a prolonged course of antibiotics. Vertebral infection resolved with this treatment in all three patients without any recurrence. Previous dexamethasone therapy, together with an episode of bacteraemia, appears to be a predisposing factor for vertebral infection. Magnetic resonance imaging enabled the diagnosis in all three patients.
Desikan
Raman
R
Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Barlogie
Bart
B
Sethi
Rajesh
R
Toor
Amir
A
Spoon
Dan
D
Angtuaco
Edward
E
Vanhemert
Rudy
R
VijayaGopal
Anantha
A
Singhal
Seema
S
Mehta
Jayesh
J
Jagannath
Sundar
S
Munshi
Nikhil
N
Zangari
Maurizio
M
Fassas
Athanassios
A
Tricot
Guido
G
Anaissie
Elias
E
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001416:Back Pain / Q000175:diagnosis / Q000209:etiology; D015299:Discitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D010146:Pain / Q000188:drug therapy / Q000209:etiology*; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D000900:Anti-Bacterial Agents