Acute Vertebral Osteomyelitis Research Articles

Acute vertebral osteomyelitis a descriptive study of a series of 40 cases in a tertiary care hospital.

Acute vertebral osteomyelitis a descriptive study of a series of 40 cases in a tertiary care hospital.

First reported case of vertebral osteomyelitis due to Erysipelothrix rhusiopathiae

We describe a case of acute vertebral osteomyelitis with associated prevertebral abscess due to Erysipelothrix rhusiopathiae in an immunocompetent adult with recent known traumatic inoculation from the barb of a fish.

Hämatogene Spondylitis

Vertebral osteomyelitis is the main manifestation of hematogenous osteomyelitis in patients aged over 50 years. Because of an increasing multimorbidity of the primarily elderly patient population the incidence is increasing. Diagnosis is often delayed due to the rarity of the disease, the uncharacteristic symptoms and the high frequency of low back pain in the general population. Staphylococcus aureus followed by Escherichia coli (E. coli) are the most commonly isolated pathogens and the lumbar spine the most commonly affected area. Magnetic resonance imaging is the preferred radiologic modality because of its sensitivity. Computer tomography guided bone biopsy or blood cultures are crucial in the evaluation of the infection. Antimicrobial therapy of at least 6 weeks duration is recommended and should be tailored to the pathogens recovered from the culture. Acute vertebral osteomyelitis can usually be treated with antibiotics alone. Surgery is indicated in cases of persistent instability related pain, neurologic symptoms and abscess formation.

Acute Hematogenous Osteomyelitis of the Odontoid Process in a Child With Torticollis

Acute vertebral osteomyelitis is rare in the pediatric population. Its presentation may be subtle and without constitutional manifestations. We present a case of osteomyelitis of the odontoid process. The disease was not considered in the initial evaluation of an afebrile, nontoxic child who presented for evaluation of neck stiffness. Although there was a delay in diagnosis and treatment, the outcome was favorable.

Reconstruction of large defects in vertebral osteomyelitis with expandable titanium cages

The purpose of this study was to investigate the outcome of expandable titanium cage implantation in large defects caused by acute vertebral osteomyelitis. Twenty-five patients with acute single or multilevel spondylodiscitis were treated after radical débridement and posterior instrumentation with an anterior expandable titanium cage and bone grafting. Clinical, laboratory and radiological follow-up continued for 36 months. Within the postoperative course there was no recurrence of spinal infection. The final radiological examination showed successful fusion in all cases without implant loosening or failure. At the final follow-up after 36 months the Oswestry Disability Index was 23 +/- 14 and the pain visual analogue scale 2.1 +/- 1.7. This study reveals healing and improved function after expandable titanium cage implantation in all patients. Prerequisites for optimal healing include radical débridement, provision of stability for weight-bearing, adequate bone grafting and correction of deformity using rigid implants.

Cervical osteomyelitis caused by Burkholderia cepacia after rhinoplasty

Burkholderia cepacia, previously known as Pseudomonas cepacia, has been implicated in vertebral osteomyelitis in patients who are intravenous drug abusers. We report a case of acute vertebral osteomyelitis in a non-intravenous drug user, following an elective rhinoplasty.

Acute Vertebral Osteomyelitis

A 77-year-old man with diabetes presented with a four-day history of fever and worsening left-sided neck and shoulder pain accompanied by numbness and paresthesias in the fingers of the hand on the same side. Physical examination revealed severely restricted neck movement and marked palpable neck tenderness over the fourth, fifth, sixth, and seventh cervical vertebrae. The patient underwent integrated positron-emission tomographic and computed tomographic scanning because a pacemaker was present and magnetic resonance imaging could not be performed. The scans (Panels A and B) demonstrated an intense focal area of abnormal hypermetabolism confined to the left aspect of the fourth . . .

Epidemiology of acute vertebral osteomyelitis in Denmark: 137 cases in Denmark 1978-1982, compared to cases reported to the National Patient Register 1991-1993.

We studied the epidemiology of acute, non-tuberculous, hematogenous vertebral osteomyelitis in Denmark during 1978-1982. 137 patients fulfilled the criteria for acute vertebral osteomyelitis. The incidence was 5/mill/year. There were no cases in the age group 20-29 years. The highest incidence was between 60-69 years (18/mill/year). The prevalence was 15 cases. The mean duration of the disease was 7 months. The lumbar spine was affected in 59%, the thoracic spine in 33% and the cervical spine in 8% of the cases. Insulin-dependent diabetes and treatment with systemic corticosteroids seemed to be significant risk factors, but not rheumatoid arthritis and abuse of alcohol or intravenous drugs. We found no demographic variables of importance for the incidence. In 46%, a primary focus was identified, urinary tract infection being the commonest. According to the National Patient Register 1991-1993, the relative number of reported patients with vertebral osteomyelitis had increased in the age group 20-49 years, compared to 1978-1982, but the incidence was highest in the group aged 60-79 years.

Bacterial endocarditis presenting as acute vertebral osteomyelitis: 14 cases.

Association between bacterial endocarditis (BE) and vertebral osteomyelitis (VO) has infrequently been noted. In a retrospective analysis of BE (280 cases) and VO (150 cases) 14 cases were found to have this association. There were 12 males and 2 females, ages ranging from 39 to 72 years, mean age 56.6. Blood cultures were positive for Streptococcus viridans (6 cases). Str. faecalis (4 cases), staphylococcus (2 cases), Gram negative bacteria (1 case). Organism was not isolated in one case. Fever and severe back pain antedate the diagnosis of VO 3.5 and 2.5 months. X rays films of the spine and bone scans (4 cases) revealed lumbar (6 cases) or cervical (4 cases), or dorsal (3 cases) or combined cervical and dorsal (1 case) locations. History of murmur (4 cases) and development of mitral (8 cases) or aortic (4 cases) or combined mitral and aortic (2 cases) insufficiencies were consistent with concomitant BE. Echocardiogram revealed vegetations in 6 out of 9 cases. Patients received antibiotic therapy for 3.5 months. Ten patients were cured with antibiotics only, 4 required valve replacement. One died. Thus age, sex, history of heart disease, valvular involvement, duration of symptoms prior to admission and bacteriological pictures are the same in BE with VO as in BE without VO. Survival rates are also the same if early recognition of BE and VO with prompt and prolonged antibiotic therapy may prevent severe haemodynamic or vertebral problems.