Abstract
Background: The incidence of pyogenic spinal infection has increased in recent years. In addition to treatment of the spinal infection, early diagnosis and therapy of coexisting infections, especially of secondary brain infection, are important. The aim of this study is to elucidate the added value of routine cerebral imaging in the management of these patients.Methods: This was a retrospective single-center study. Cerebral imaging consisting of cerebral magnetic resonance imaging (cMRI) was performed to detect brain infection in patients with a primary pyogenic spinal infection.Results: We analyzed a cohort of 61 patients undergoing cerebral imaging after diagnosis of primary pyogenic spinal infection. The mean age in this cohort was 68.7 years and the gender distribution consisted of 44 males and 17 females. Spinal epidural abscess was proven in 32 (52.4%) patients. Overall positive blood culture was obtained in 29 (47.5%) patients, infective endocarditis was detected in 23 (37.7%) patients and septic condition at admission was present in 12 (19.7%) Patients. Coexisting brain infection was detected in 2 (3.3%) patients. Both patients revealed clinical signs of severe sepsis, reduced level of consciousness (GCS score 3), were intubated, and died due to multi-organ failure.Conclusions: Brain infection in patients with spinal infection is very rare. Of 61 patients with pyogenic spinal infection, two patients had signs of cerebral infection shown by imaging, both of whom were in a coma (GCS 3), and sepsis.
Highlights
The incidence of spondylodiscitis in western countries has been rising over recent decades
In collaboration with our colleagues from the Infectious Diseases Unit, cerebral imaging for detection of brain infection in patients with spinal infection was performed after confirmation of the spinal infection to elucidate the proportion of coexisting brain infection
No prior surgery was performed on these two patients
Summary
The incidence of spondylodiscitis in western countries has been rising over recent decades. Cerebral Imaging in Spinal Infection number of comorbidities [6,7,8]. The incidence of coexisting brain infections in these patients is still unclear. Early diagnosis and treatment of brain infection are important for a patient’s outcome. The aim of the present study is to highlight the incidence of secondary brain infection, risk factors, and clinical outcomes in patients with pyogenic spondylodiscitis admitted to a university spine surgery unit. The incidence of pyogenic spinal infection has increased in recent years. In addition to treatment of the spinal infection, early diagnosis and therapy of coexisting infections, especially of secondary brain infection, are important. The aim of this study is to elucidate the added value of routine cerebral imaging in the management of these patients
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