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At least 613 records · Page 34Linked to original sources
PubMed1998

[2 cases of iatrogenic oral streptococcal infection: meningitis and spondylodiscitis].

INTRODUCTION: The multiplication of invasive spine investigations for either diagnostic or therapeutical purposes increases the risk for iatrogenic infections. We report two cases of iatrogenic infections, one case of meningitidis and one case of spondylodiscitis due to Streptococcus viridans. EXEGESIS: The two cases included a 42-year-old male patient presenting with spondylodiscitis due to Streptococcus oralis following nucleolysis for discal node and a 51-year-old female patient with purulent meningitidis due to Streptococcus salivarius following hysteroscopy with spinal anesthesia. According to the disease chronology and bacterial results, iatrogenesis was evidenced. The streptococci originate from the patient's skin or from the operators' endobuccal flora. CONCLUSION: Simple aseptic rules, including wearing a surgical mask during any spinal tap, would definitely avoid iatrogenic infections.

Adult↗
PubMed2001

Hematogenous cervical spondylodiscitis after severe burn injury.

A 47-year-old man sustained a 31% TBSA burn injury. In spite of early escharectomy and mesh-graft-transplantation the patient suffered a septicaemic phase in the first week, which was treated by a specific antibiotic. Five weeks after the burn injury a cervical spondylodiscitis was diagnosed. Immediate wound debridement, ventral and dorsal spondylodesis with a tricortical bone-graft from the left iliac crest and titanium plates and specific antibiotic therapy led to the stabilization and healing of the cervical spinal column. The spondylodiscitis was microbiologically proved to be hematogenous after spread of Staphylococcus aureus from the blood in the early septicaemic phase. Swab culture from the burn surface wound, infected vertebrae and blood during the septicaemic phase revealed coagulase positive S. aureus. The aetiology, predisposing factors and management of this rare, but recognized, complication of major burns are discussed. Case features of this patient are compared with the single site's reported case of hematogenous cervical spondylodiscitis after severe burn injury.

Anti-Bacterial Agents↗
PubMedDate not supplied

Penicillin--intermediate-resistant pneumococcal spondylodiscitis.

Pneumococcal osteomyelitis probably was more common in the pre-antibiotic era, but currently is rare. Sickle-cell disease and possibly, bone trauma and advanced age are predisposing factors for pneumococcal osteomyelitis. Bone infection usually occurs as a result of hematogenous spread from an infective focus, which often cannot be identified. In patients without evidence of other focci of infection, pneumococcal spondylodiscitis probably is caused by "primary" pneumococcal bacteriemia, originating in the oropharynx, especially if the patient has alterations that disrupt the oropharyngeal mucose. Whereas early in the antibiotic era, all Streptococcus pneumoniae strains were susceptible to penicillin, resistance to this antibiotic is on the rise, and in many parts of the world, it has emerged as a major problem. We report the case of a young patient with penicillin-resistant pneumococcal vertebral and intervertebral disk disease who had no evidence of pneumococcal infection elsewhere, and we discuss the possible mechanism of infection. We also review briefly the resistance to penicillin of S. pneumoniae and the treatment of choice.

Adolescent↗
PubMed2005

[Enterobacter cloacae spondylodiscitis through misuse of high-dose intravenous buprenorphine].

INTRODUCTION: We report a case of Enterobacter cloacae spondylodiscitis related to risk practices in intravenous drug addicts (IVDA). OBSERVATION: The patient, a former heroin addict, was receiving long-term, high-dose buprenorphine maintenance treatment. He had been misusing the treatment, injecting it daily for several months. The clinical course included several uncommon features that are usually found in IVDA patients: subacute infection, apyrexia, and minimal inflammatory syndrome. This infection also led to the discovery of his HIV infection. DISCUSSION: Any dorsolumbar pain in IVDA patients, including those receiving regular drug maintenance treatment and especially those with HIV infection, should suggest spondylodiscitis, because of these patients' enhanced sensitivity to infection and the frequent bacteremia caused by persistent or transitory relapse involving injection (exchange of material, reuse of needles, syringes, cotton swabs, and risk of contamination through the hands or saliva).

Adult↗
PubMed1993

The postoperative lumbar spine: imaging considerations.

MRI with intravenous contrast has recently become the imaging modality of choice in the evaluation of patients developing recurrent back pain or symptoms following laminectomy and/or discectomy. The normal postoperative appearance is important to recognize because a number of changes occur normally throughout the healing period. The difference between epidural scar and recurrent disc herniation can usually be determined on MRI. Postoperative fluid collections may also develop. Disc space infection, although uncommon, is a critical diagnosis, but can be confused with degenerative end plate changes. Arachnoiditis and spinal stenosis also show characteristic imaging findings.

Arachnoiditis↗
PubMed2002

The juvenile-onset spondyloarthritides.

The juvenile-onset spondyloarthritides comprise a group of HLA-B27-associated disorders, which are mainly characterized by enthesitis and arthritis affecting the lower extremities, and in a variable proportion of cases, the sacroiliac and spinal joints. Additional features include a variety of extra-articular manifestations, and in some cases, bacterial infections as triggers. Except for the prevalence of some clinical features at onset and severity throughout the course of the disease, juvenile-onset SpA resemble their adult counterpart in most clinical aspects, strength of HLA-B27 association, and the role of arthritogenic bacteria in their pathogenesis. Not surprisingly, several aspects, from nomenclature to classification, and diagnostic criteria reflect to some extent those developed in the adult onset populations.

Age of Onset↗
PubMed1986

Intervertebral disk space infection following translumbar aortography.

After 1,748 translumbar aortograms three cases of intervertebral disk space infection were observed over a five-year period, for an incidence of 0.15%. Cultures suggested that the intervertebral disk had been inoculated with digestive tract organisms by the needle used to puncture the aorta. Diagnosis of this complication can be made early by retrieval of the responsible organisms from the intervertebral disk under CT control. Treatment consists of prolonged immobilization associated with appropriate antibiotic therapy for at least three months.

Adult↗
PubMedDate not supplied

Infectious spondylodiscitis: magnetic resonance imaging in HIV-infected and HIV-uninfected patients.

OBJECTIVE: We retrospectively reviewed 21 infections of the spine to correlate magnetic resonance imaging (MRI) with etiology of spondylodiscitis according to HIV status. CONCLUSION: MRI allowed the differentiation between tuberculous and pyogenic spondylodiscitis in the chronic stage. Typical findings were not observed in HIV+ as compared with HIV- patients, either concerning etiology or characteristic features of the spondylodiscitis.

Adult↗
PubMedDate not supplied

Brucellar spondylodiscitis: MRI diagnosis.

Early diagnosis of brucellar spondylodiscitis is often difficult because of the long latent period. Radiographs of the spine, bone scan, and computed tomography (CT) scan provide insufficient data. Among 25 patients with brucellar spondylodiscitis studied by magnetic resonance imaging (MRI), 9 were in the acute stage and 16 were in the chronic stage. MRI is the investigation method of choice in diagnosing brucellar spondylodiscitis.

Adolescent↗
PubMed2002

[Surgical treatment of patients with spinal infection].

INTRODUCTION: The surgical treatment of spinal infection, relegated because of the development of more effective antibiotherapy and the fear of associated morbidity, is springing up again with the increase of new patients with weakening pathology. MATERIAL AND METHODS: The clinical records of 27 patients submitted to surgery because of spinal infection between January 1990 and December 1999 at our service have been retrospectively studied. They were assessed with the Frankel and Karnofsky clinical scales, and the radiological angulation of the spine. RESULTS: Male (n = 17) and dorsal lesions (n = 14) predominate. Most of patients presented with pain, and 13 had neurological compromise. 29 operations were performed on the 27 patients. One of them was previously operated upon before the period considered, that procedure has been excluded. The total surgeries performed were 5 simple and 4 instrumented laminectomies, 6 simple corpectomies, 10 corpectomies with anterior instrumentation and 4 with posterior instrumentation. One patient died, there was not definitive morbidity and any patient deteriorated on clinical scales although radiology was not always improved. DISCUSSION AND CONCLUSIONS: The aggressive treatment of spinal infection is indicated when conservative means are insufficient. Surgery permits a better recovery of the neurological deficit, and prevents spinal deformity and pain produced by the disease.

Adolescent↗
PubMed2003

[Cauda syndrome due to spinal stenosis and diskytis in two different spinal levels. Diagnosis using myelo-TC].

We report a case of a 75 year old man presenting with paraparesis, urinary incontinence and saddle anesthesia evolving after several months and severe lumbalgia and bad general status which developed fewdays before admission. CT-scan showed spondilosis with lytic lesion at L5-S1 level. MR1 was not performed because the patient had a pacemaker. A myelo-CT study was performed showing a complete stop at L4-L5 level together with L5-S1 diskytis. Laminectomy of L5 and discectomy L5-S1 was performed obtaining tissue sample diagnostic of diskytis and osteomyelitis. Our patient had two lesions at two different levels with two independent syndromic appearence. Myelo-CT played an important diagnostic role in this case because MRI study could not be obtained.

Aged↗
PubMed2003

Lack of association between lumbar disc degeneration and osteophyte formation in elderly japanese women with back pain.

Our study was designed to assess the contributions of the physical and constitutional factors to osteophyte formation, disc degeneration, and bone mineral density (BMD) in lumbar vertebrae of elderly postmenopausal women. A total of 126 Japanese women with back pain, aged over 60 years, were invited to participate in the study. Then 80 subjects with a full set of data for physical examinations, radiographs, MRI, and DXA were examined. TaqI polymorphism of vitamin D receptor (VDR) gene was examined in 60 subjects. Prevalence rates of osteophytes (on radiographs) and disc degeneration (on MRI) were 61 and 68%, respectively. Body weight and BMI correlated significantly with anteroposterior (AP) and lateral (LAT) BMD (r = 0.354 for weight, r = 0.347 for BMI) and mean osteophyte area (r = 0.557 for weight, r = 0.486 for BMI), and body weight also correlated with number of discs with osteophytes. However, these did not correlate with the disc area or the number of degenerated discs. Stepwise regression analysis revealed that body weight and LAT-BMD values independently related to the osteophyte area. Disc area (r = 0.386 for AP view) and osteophyte area (r = 0.384 for AP view) significantly correlated with BMD. However, disc area and osteophyte area did not correlate with each other (r = 0.056). The proportion of degenerated discs was higher in the lower lumbar discs, but not the proportion of discs with osteophytes. Frequencies of T and t alleles of VDR did not correlate with disc degeneration, osteophyte formation, or osteoporosis. Our data showed that increases in osteophyte formation and BMD in the lumbar vertebrae are influenced by body weight and BMI, but did not correlate with disc area, which correlated inversely with BMD. Disc degeneration and osteophyte formation seem to represent two different factors that affect lumbar spine in elderly women.

Aged↗