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腰痛と微熱を発症する二つの病気と特徴

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腰痛を発症している時に微熱があるときには色々な原因があると言われていますが、一般的に二つの症状を発症する病気には風邪やインフルエンザなどがあります。これらの病気は適切に処置をすることで自宅でも完治することができますが、これ以外の病気が原因の場合には放っておくと大変危険なものもあります。

では、そのような病気とは一体どのような物なのでしょうか?今回は、腰痛と微熱を発症する二つの重大な病気について紹介しておくことにします。

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化膿性脊椎炎

二つの病気の中から、まずはこの化膿性脊椎炎から見ていきましょう。

疾患に至る原因は何か

MRI

この病気が発症する原因は、体内に侵入した黄色ブドウ球菌や他の細菌、さらにカビの一種などが脊椎に寄生することで脊椎が化膿してしまうところにあります。これらの原因菌が脊椎に感染する経路は血液からだという事がわかっており、泌尿器系や生殖器系、そのほか胆嚢の疾患から原因菌に感染すると言われています。

免疫機能が低下していると感染率が高くなるため、基礎疾患に糖尿病や肝機能障害、悪性腫瘍を患っている人に多くみられると言われています。また、高齢者も抵抗力が低下しているため感染率が高いという事もわかっています。

どのような症状を発症するのか

通常の発症の仕方だと微熱と共に腰痛があり、化膿している脊椎の場所を刺激すると疼くような痛みがあるのが特徴です。疾患部位に膿が蓄積するとやがて神経を圧迫するようになり、脊髄麻痺を起こしさらに症状が進むと下半身にしびれや麻痺を発症することもあります。

また、稀に急性な症状の現れ方をすることもありますが、そのような場合は激痛と高熱を発すると言われています。いずれの場合にも症状の重さに差があるものの、内容は変わらないと言われています。

検査方法と治療方法とは

感染部位は脊椎同士を支える椎間板と脊椎の接点にみられるため、まずはその正確な位置を確認するためにレントゲンを撮影します。血液検査では白血球の増加と炎症が発症をしていることを表すCRPの数値を見て判断します。ただ、決定的な診断のためには直接患部の組織を採取することもあります。

これらの検査によって化膿性脊椎炎だと診断されたら、入院による安静が必要になります。日常程度の負担だといえどもその負担を続けることで疾患部位の炎症が広がってしまいかねないからです。抗生物質や点滴などの投薬と共に、体幹ギブスなどを使って体を動かさないように固定します。

また化膿が進んで脊椎に膿があまりにもたまっている場合にはその膿を摘出する手術を行う場合もあります。

基礎疾患を抱えている場合には、その治療も大切になるため、外科と内科の連携で治療が進められることになります。特に糖尿病などの生活習慣病は免疫機能に大きな障害をきたしますので、これらの病状を抑制することで脊椎炎の炎症に対する免疫力を高めていかなければなりません。

治療の期間は抗生物質や点滴などの投与がおよそ1か月程度で、その後の病状によって個人差があるものの処方薬による自宅療養はおよそ2~3か月程度と言われています。

脊椎カリエス

では続いてもう一つの病気について見ていくことにしましょう。

疾患に至る原因は何か

脊椎カリエスも可能性脊椎炎と同じく血液から原因菌に感染することで発症するという事がわかっています。この脊椎カリエスの原因菌は結核菌で、肺から血液を介して結核性の脊椎炎を引き起こします。主な原因菌の発生場所は肺の疾患ですが、ごく稀に肺の疾患がない場合に泌尿器系の疾患が原因菌を保有している場合があるという事もわかっています。

この脊椎カリエスは患者数が低下しつつあるものの、高齢者に比較的発症の傾向がみられると言われています。

どのような症状を発症するのか

微熱と腰痛のほかに全身の倦怠感や悪寒、食欲不振が代表的な症状ですので、一般的な腰痛で体調がすぐれない時と左程症状が変わらないことがこの疾患を発見しにくい一つの要因にもなっています。ただ、腰痛に関しては腰にとどまらず背中に疾患がある場合もあり、患部を刺激すると疼くような痛みがあります。また、化膿性脊椎炎と比較すると症状が穏やかであることが特徴です。

膿が溜まるようになるとお腹やお尻、股関節に突っ張り感や重さなどの違和感が出るようになり、痛みが出るようになると関節を動かすことが困難になり、やがてしびれや麻痺を起すようになりますし、骨の状態が著しく変化することで湾曲してしまう事もあります。

検査方法と治療方法とは

レントゲンやCT撮影で患部を確認することができます。また、血液検査でもわかることから検査方法においては可能性脊椎炎と同じです。血液検査では白血球数やCRP値のほかにツベルクリン反応を見たり喀痰検査も行います。MRIによる精密検査で病状の詳細が把握することができ、感染している骨の組織状態や病状の進行度などを詳しく知ることができます。

治療には主に化学療法がおこなわれます。抗結核菌薬の投薬と共に入院による安静が原則的な治療になります。進行度にもよりますが結核菌による骨の障害が重度の場合や麻痺が症状として現れているような場合には骨が重度の変形に至る可能性があるためその進行を食い止める手術が必要になります。療養期間は症状の重さによって非常に差があり、また個人の免疫力や体力によってもさらに差が生じるためその期間を定めることは難しいと言われています。

発見が早ければその分病状を悪化させずに済みますし、近年ではRNA検査やDNA検査でも早期に診断が可能になっています。

Dr.お医者さんの円座クッションA
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まとめ:腰痛と微熱を同時に発症したら早急に病院へ

これらの病気に限らず言えることですが、症状が悪化してしまう前に原因をはっきりさせるためにもこのような症状が生じたら速やかに病院に行くようにしましょう。重大な病気であるならば尚更早期に治療を始めることでその症状を軽くすることができますし、早く治すこともできます。

日々の健康を守っていくためにも、日常の自分の体の変化には気を付けておくようにしたいものですね。

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