title: Spinal lesions by infectious spondylodiscitis and hepatocellular carcinoma presenting as spinal metastasis in an HIV-HCV co-infected patient.
abstract: Back pain and spine tenderness over the involved spine segment are common clinical findings of a number of relative benign conditions. However, back pain may be the presenting symptom of vertebral metastases in patients with systemic cancer, including hepatocellular carcinoma, a not uncommon complication in HCV-HIV infected patients. We describe a case of a 51-year-old intravenous drug user with HIV and HCV co-infection who developed dorsal spondylodiscitis due to Pseudomonas aeruginosa, which improved following antibiotic therapy. Three months after the end of therapy, the patient referred recurrence of back pain. The MRI showed different vertebral lesions of the dorsal spine and costal arch which turned out to be hepatocellular carcinoma metastasis at the histological examination. The patient had never been treated with the interferon-ribavirine combination therapy because of a major depressive syndrome. Interferon-free regimens are urgently required for HIV-HCV coinfected patients, especially when interferon-based regimens are contraindicated.
authors.affiliation: Infectious Disease Unit; Unit of Radiology, University Hospital of Trieste, Trieste, Italy.
authors.forename: Gilda
authors.initials: G
authors.lastname: Tonziello
authors.affiliation: Infectious Disease Unit; Unit of Radiology, University Hospital of Trieste, Trieste, Italy.
authors.forename: Romina
authors.initials: R
authors.lastname: Valentinotti
authors.affiliation: Infectious Disease Unit; Unit of Radiology, University Hospital of Trieste, Trieste, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Stacul
authors.affiliation: Infectious Disease Unit; Unit of Radiology, University Hospital of Trieste, Trieste, Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Giacomazzi
authors.affiliation: Infectious Disease Unit; Unit of Radiology, University Hospital of Trieste, Trieste, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Luzzati
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000556:secondary; D060085:Coinfection; D003937:Diagnosis, Differential; D015299:Discitis / Q000175:diagnosis / Q000382:microbiology*; D015658:HIV Infections / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D016867:Immunocompromised Host; D008113:Liver Neoplasms / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000150:complications*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012008:Recurrence; D012307:Risk Factors; D013125:Spinal Neoplasms / Q000150:complications* / Q000556:secondary; D015819:Substance Abuse, Intravenous / Q000150:complications; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents