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At least 667 records · Page 37Linked to original sources
PubMed1998

Anterior cervical epidural abscess treated by endoscopy-assisted minimally invasive microsurgery via posterior approach.

This is a report of clinical manifestation, physical findings, neurophysiological data, magnetic resonance imaging, and results after surgery in a 71-years-old man with cervical abscess. Magnetic resonance imaging after two weeks of empiric antibiotic therapy demonstrated the persistence of an anterior cervical epidural collection and signs of spondylodiscitis at the C5-C6 and C6-C7 levels. Surgery was performed by posterior endoscopy assisted key-hole approach at the C2-C3 level to drain the abscess and to decompress the spinal cord. Postoperative specific medical treatment was then administered. A successful outcome, at 24 months follow-up, was achieved by surgery with complete clinical recovery, resolution of the abscess and healing of the spondylodiscitis. After unsuccessful blind medical therapy the minimally invasive microsurgical technique allowed us to keep the surgical injury of the healthy tissue to a minimum while producing the maximum therapeutic effect.

Abscess↗
PubMedDate not supplied

[Percutaneous CT-controlled puncture and drainage of spondylodiscitis--a minimally invasive method].

PURPOSE: Is there an absolute operative indication for the abscess-forming spondylodiscitis or is a curing also possible with minimal invasive procedures? METHOD: In a retrospective study over a period from 1986 to 1993, 40 patients with a spondylodiscitis of the thoracic and lumbar spine were treated and then followed up over two years in our Department of Orthopedic Surgery. Using a CT-controlled method of minimal invasive punction and drainage of the abscessed forms of spondylodiscitis, it was to be settled whether these therapeutic procedures result in a normalization of the biochemical inflammatory parameters (CRP) and in a normalization of the CT--as well as MRI-findings. RESULTS: 7 of the 40 patients had a spondylodiscitis with a local abscess, further 7 patients had a gravidation abscess. 92.5% of the cases were treated conservatively and minimal invasively, respectively. In 11 patients the minimal invasive procedure was used in addition to conservative therapy. 3 cases had to be operated on. A recurrence of the spondylodiscitis was seen in 1 patient; complications (n = 2; 1 x pneumonia, 1 x venous thrombosis) occurred in 5% of all patients. CONCLUSION: Minimal invasive therapy with CT-controlled punction or drainage may be a good alternative to the operative intervention in the predominantly old and multimorbid patients with abscessed forms of spondylodiscitis. The risk is minimized, the immobilizing period was 8.7 weeks on average.

Abscess↗
PubMed1988

[Spondylodiscitis following lumbar intervertebral disk surgery. Clinical aspects--diagnosis--therapy].

From 1980 to 1986 6632 operations of the lumbar spine due to disc prolapse were carried out by the Department of Neurosurgery of the hospital of the Technical University of Munich. During this period we saw 14 cases of postoperative spondylodiscitis. Patients' main symptom was increasing low back pain. Physical examination showed difficulty in forward flexion of the body. The blood sedimentation rate was always examined: an average increase to 42/66 mm was recorded. X-ray examination of the lumbar spine and magnetic resonance imaging proved to be the most sensitive methods of investigation, better than scintigram and computed tomography. Our therapeutic management consists of fixation in normal position with a "Light Cast" corset and additional antibiotic therapy with cephadroxil. In comparison to other therapy methods, i.e. restcure, the advantage for our patients is that they can stay at home and move about. Therapy must be continued until the blood sedimentation rate is normal and radiological signs of consolidation can be seen for at least over 10 weeks. Good long-term results were seen in all patients.

Adult↗
PubMed1994

[Lumbar spondylodiscitis caused by Salmonella enteritidis].

A 19-year-old boy developed paravertebral muscular pain in the lumbar region after an episode of extremely arduous sporting activity, with fever followed by meningism. The cerebrospinal fluid showed a reactive pleocytosis. Initially, no acute inflammatory changes were present on serum and blood analysis, although the erythrocyte sedimentation rate was moderately increased to 25/60 mm. Pyrexia of up to 38.5 degrees C developed 6 days after admission. Because Borrelia IgM and IgG titres were positive, the diagnosis was at first thought to be atypical borreliosis and the patient was treated with antibiotics. However, after a further episode of fever. Salmonella antibody titres, which had initially been normal, rose to 1: 3200 (Salmonella typhi O and H antigens) and 1: 12800 (Salmonella enteritidis, H antigen). At this stage, the erythrocyte sedimentation rate rose to 86/120 mm and the C-reactive protein to 77 mg/dl. The white cell count remained normal throughout. Blood cultures grew Salmonella enteritidis. Abnormalities on bone scintigraphy were confirmed by CT and MRI scans, showing spondylodiscitis of lumbar vertebrae 1 and 2 with limited osteolysis. The lesion resolved completely on 6 week's treatment with ciprofloxacin (200 mg twice a day intravenously) and conservative supportive treatment. Spondylodiscitis is an uncommon complication of salmonellosis and may occur long after the diarrhoea. Cross reactions with Borrelia flagellin antigens may lead to the wrong diagnosis being made.

Adult↗
PubMed1993

[Sepsis and spondylodiscitis caused by Salmonella enteritidis].

Four weeks after an attack of bronchopneumonia a 59-year-old veterinary surgeon developed backache. The chest radiograph showed an impression fracture of the 11th thoracic vertebra. Persisting fever led to hospitalization. Several blood cultures grew Salmonella enteritidis. Computed tomography demonstrated a fracture of the 11th thoracic vertebra with osteolytic infiltration and paravertebral soft-tissue infiltration. Bone scan showed band-like contrast enhancement in the same area. Treatment at first consisted of Ciprofloxacin, 200 mg twice daily intravenously for 5 days, then 750 mg orally twice daily for 3 months. The fever regressed within a few days. Sclerosis of the affected vertebral area became radiologically evident after 6 weeks. After this the patient was allowed to move around again, without any further problems.

Ciprofloxacin↗
PubMed2002

Psoas abscess diagnosed at a Northern university hospital.

Abscess of the psoas muscle is an infrequent diagnosis at hospitals in Northern countries. We report on 16 patients who had this diagnosis during the period 1991-2001. Eight patients were immigrants who had previously been healthy and most of them had experienced symptoms for approximately 1 y. MRI or CT scans revealed spondylodiscitis in 6 of these patients and Mycobacterium tuberculosis was identified as the causative agent. With the exception of 1 patient who was exclusively treated with antituberculous agents, all 8 immigrant patients were successfully treated with antituberculous agents in addition to percutaneous drainage. The other 8 patients were Norwegians, 4 of whom had underlying conditions such as diabetes mellitus or drug abuse. The causative microorganisms were Staphylococcus aureus or Streptococcus spp., with the exception of M. tuberculosis in 1 case. The Norwegian patients had a more acute history of symptoms than the immigrant patients and 2 of them were in a septic condition on admittance. Two of the Norwegians died of serious infection; 5 were successfully treated with percutaneous drainage in addition to antibiotics and 1 was treated exclusively with antibiotic agents. The clinical history and microorganism associated with psoas abscess seemed to depend on whether or not the patient was an immigrant. Owing to increasing immigration, diagnosis of psoas abscess should be taken into account in Northern countries.

Adult↗
PubMed2003

Postoperative spondylodiskitis due to Stomatococcus mucilaginosus in an immunocompetent patient.

A case is reported of postoperative spondylodiskitis due to Stomatococcus mucilaginosus in an immunocompetent woman. The route of infection remains unknown. Intravenous treatment with cefotaxime and fosfomycin was given, followed by oral administration of rifampin and pristinamycin until resolution of infection. This report shows that this bacterium can cause severe infections in immunocompetent patients.

Adult↗
PubMed2003

Spondylodiscitis due to Aerococcus urinae: a first report.

Aerococcus urinae is an uncommon urinary tract pathogen which causes infections predominantly in elderly persons with local and general predisposing conditions. There are few case reports of severe infections caused by Aerococcus urinae among which only 14 cases of endocarditis caused by Aerococcus urinae have been reported. We report the first case of Aerococcus urinae spondylodiscitis. The patient responded to 4 weeks of amoxicillin and clindamycin, and to 5 months of amoxicillin alone.

Aged↗
PubMed2004

Susceptibility of Mexican brucella isolates to moxifloxacin, ciprofloxacin and other antimicrobials used in the treatment of human brucellosis.

Brucellosis is a disease of domestic and wild animals that is transmitted to humans and exists worldwide. We assessed the in vitro activity of moxifloxacin, ciprofloxacin, tetracycline, doxicycline, rifampin, streptomycin and trimethoprim-sulfamethoxazole (TMP/SMX) against 97 Brucella strains isolated from clinical samples, animals and dairy products in Mexico. Fluoroquinolones showed an antibacterial activity similar to that of tetracyclines (MIC(90) 0.5). Other drugs commonly used against brucellosis were less active, such as rifampin (MIC(90) 2.0 microg/ml) and streptomycin (MIC(90) 4.0 microg/ml). TMP/SMX showed the poorest activity (MIC(90) 8.0 microg/ml). Fluoroquinolones, either first-generation or the newer 8-methoxi derivatives, might be useful in the therapy of brucellosis, which remains to be assessed in clinical trials.

Anti-Bacterial Agents↗
PubMed2006

Spondylodiscitis due to Bacteroides fragilis: two cases and review.

Non-iatrogenic spondylodiscitis caused by anaerobic bacteria remains exceptional. We describe 2 cases of spondylodiscitis with epidural abscess due to Bacteroides fragilis, 1 after colonoscopy with biopsy and 1 in a cirrhotic patient. The clinical and imaging findings were not discriminant relative to other pyogenic spondylodiscitis. One should consider B. fragilis when treating a spondylodiscitis with epidural abscess, especially in patients with a possibly digestive portal of entry.

Abscess↗
PubMed2006

Spondylodiscitis after facet joint steroid injection: a case report and review of the literature.

Spondylodiscitis is a rare complication after facet joint steroid injection. This article presents a 78-y-old male with chronic back pain and facet joint arthritis who developed Pseudomonas aeruginosa L2-L3 and L3-L4 spondylodiscitis after computed tomography-guided facet joint steroid injection. Magnetic resonance imaging, fine needle aspiration and cultures confirmed the diagnosis. The patient was treated with intravenous administration of amikacin, and imipenem plus cilastatin for 4 weeks, followed by oral administration of ciprofloxacin for another 10 weeks. Sterile preparation prior to facet joint steroid injection should be stressed. To the best of our knowledge, this is the only reported case of iatrogenic spondylodiscitis after facet joint steroid injection. This iatrogenic complication should be considered in the risk-benefit analysis of facet joint diagnostic or therapeutic injections.

Aged↗
PubMed2006

Proteus mirabilis spondylodiscitis complicating a urinary tract infection.

Infectious spondylodiscitis results from local or haematogenous infection by microorganisms of intervertebral disc spaces, vertebral bodies and surrounding structures. Haematogenous invasion may follow urosepsis. We report on a case of septic spondylodiscitis following urosepsis with Proteus mirabilis, a frequently isolated microorganism in urinary tract infections but rarely in spondylodiscitis.

Aged, 80 and over↗