Spondylodiscitis and early diagnosis: a case report

Abstract

Context: Spondylodiscitis is a term that includes vertebral osteomyelitis, spondylitis and discitis. Among the vertebrae, the most affected are the lumbar (45%), followed by the thoracic (35%). Adults present themselves progressively, with a predominant complaint of low back pain and pain on palpation of the affected site, with significant limitation of movement due to muscle spasms. Report a clinical case with an emphasis on the possibility of early diagnosis and correct treatment aimed at the recovery of patients with neurological sequelae. Analysis of medical records in a patient admitted to the neurology ward of Santa Casa de Belo Horizonte. Clinical Case report: A.I.S. patient, 45 years old, with chronic low back pain due to asymmetry of the left lower limb. History of wear of the femoral head diagnosed in adolescence. Evolving for 2 months with progressive weakness in the lower limbs, associated with paresis and paresis in the left lower limb. He performed abdominal USG which showed hepatosplenomegaly with collateral circulation, increased caliber of the portal, splenic and superior mesenteric veins. Tomography of the lumbosacral spine with osteolytic lesions in the joints of L2-L3, L3-L4 and L4-L5., With almost total osteolysis of the L4 vertebral body, retropulsion of much later at this level, suggesting spondylodiscitis. The resonance of the lumbar spine performed with acute spondylodiscitis L2-L3 and L3-L4, compressing the roots of the equine tail with a comprehensive potential, remains as the emerging emerging roots. Liquid filling of the L3- L4 intervebral disc compatible with acute spondylodiscitis. Staphylococcus aureus and enterobacteria are responsible for more than half of the cases of non-tuberculosis. Conclusion: The diagnosis of discitis can be quite difficult, due to the rarity of the disease, the insidious symptoms and the high prevalence of low back pain in the general population. It is considered an important morbidity factor, as it causes an important neurological sequel. In addition, it points to the importance of differential diagnosis of low back pain in the population.