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1,222 records · Page 68Linked to original sources
PubMed1998

[Pneumococcal spondylodiscitis. A case report].

We report on a case of a 66 years-old patient suffering weight loss and lumbar pain, localized at L2-L3. A spondylodiscitis was revealed by CT and MRI; intervertebral disc puncture was positive for Pneumococcus Pneumoniae. The clinical evolution was good with the anti-bacterial treatment, while the patient developed a synostosis L2-L3. Incidence, bacteriology, imaging and therapy of spondylodicitis are discussed.

Aged↗
PubMed1998

[Infectious spondylodiscitis--an important differential diagnosis in backache].

All cases of spondylodiscitis diagnosed in our hospital between January 93 and April 96 have been analysed retrospectively. With regard to potentially severe complications, spondylodiscitis is an important differential diagnosis of back pain. In our results 50% of the patients had a positive bacterial culture either from blood or tissue. No complication has been observed. The most relevant diagnostic procedures are: determination of CRP, magnetic resonance imaging and eventually computed tomography in combination with biopsy and blood cultures. Magnetic resonance imaging is a very sensitive method for early stage osteomyelitis. Antimicrobial therapy should be based on the result of culture and sensitivity tests. An antibiotic with good penetration into bone is preferred.

Aged↗
PubMed1998

[The recrudescence of spondylodiscitis due to migratory flows. The role of magnetic resonance as a method of first instance in diagnosis and follow-up].

PURPOSE: We report 15 cases of spondylodiscitis due to infective processes of different etiology and stress the role of MRI in the diagnosis and follow-up of this condition, whose high epidemiologic recrudescence is probably related to an increased westward migratory flow. PATIENT AND METHODS: February through December, 1996, fifteen patients with acute spinal pain were submitted to MRI (1.0 T superconductive magnet, Magnetom SP42E, Siemens, Erlangen, Germany). In all cases both the painful spinal tract and the rest of the spine were studied to detect any infiltrative processes elsewhere in the spine. All patients underwent MR follow-up, according to the evolution of subjective symptoms, until complete recovery of the infections. RESULTS: MRI always permitted the correct diagnosis to be made and the correct evaluation of infection evolution, allowing adequate (medical and/or surgical) treatment to be carried out in the early stage of infections. DISCUSSION: MRI can be considered the best diagnostic tool study osteomedullary inflammations and, particularly, to diagnose and follow-up spondylodiscitis. This technique permits clear differentiation between the different evolution stages of the infections, as well as the evaluation of bone, disks, epidural spaces and spinal cord involvement. Moreover the MR findings permit adequate treatment choices, which results in much fewer complications and therefore better prognosis. CONCLUSIONS: The role of MRI in the diagnosis and follow-up of spondylodiscitis has been fully discussed in the literature. Our report is aimed at stressing the important role of MRI as the technique of choice for the diagnosis of suspected spondylodiscitis, especially considering the high recrudescence of this condition in Western populations which is probably related to increased westward migrations.

Adolescent↗
PubMed1998

[Inflammatory spondylodiscitis as a unique radiological manifestation of the SAPHO syndrome].

We describe two cases of SAPHO with an exclusive spinal involvement. Diagnosis was established by sterno-clavicular arthralgias, palmar and plantar pustulosis and by radiological signs of inflammatory spondylodiscitis and vertebral osteitis. Spondylodiscitis and medullary edema resolved as shown by MRI after administration of steroids in one case and methotrexate in the other.

Acne Vulgaris↗
PubMedDate not supplied

[Osteoarticular Mycobacterium xenopi infection].

BACKGROUND: Mycobacterium xenopi is a potential pathogen for man and can cause bone and joint infections, particularly spondylodiscitis. Most cases of infection occur in fragilized patients and are found more and more often in AIDS patients. CASE REPORT: A 41-year-old HIV+ woman developed cervical spondylodiscitis due to Mycobacterium xenopi infection. The strain was isolated from a discovertebral biopsy and was resistant to several antibiotics. Outcome was unfavorable. DISCUSSION: Most of the cases reported to date have involved spondylodiscitis of the thoracic or lumbar spine. To our knowledge, this is the first report of cervical spondylodiscitis dut to Mycobacterium xenopi in an HIV+ patient. Antibiotic combinations using fluoroquinolones and new macrolides are usually prescribed. Such protocols may provide cure of these opportunistic infections in immunodeficient patients.

AIDS-Related Opportunistic Infections↗
PubMed1998

[Psoas abscess secondary to lumbar spondylodiscitis caused by gram negative bacilli].

The association between psoas abscess and lumbar spondylodiscitis by Gram negative bacilli represents a rare clinical entity. Sometimes the absence of demonstrative symptoms complicates the diagnostic schema. We report about a 72 year-old woman, without previous known diabetes mellitus, who was admitted because of fever of one week duration and a non-ketotic hyperosmolar coma. A left psoas abscess was identified by abdominal computed tomography (CT). The abscess was in communication with the L1-L2 intervertebral space. Although Escherichia coli was identified as the causing agent and appropriate antibiotic therapy was administered, the resolution of the abscess occurred only after the implantation of a percutaneous catheter guided by CT without additional surgery. Percutaneous drainage as a diagnostic-therapeutic technique has rendered the surgery as the last resort in the treatment of psoas abscess.

Aged↗
PubMed1998

[CT-guided spinal biopsy in spondylodiscitis].

Since February 1987 percutaneous CT-guided spine biopsy was performed in 18 patients with spondylodiscitis at the X-ray Department of Bispebjerg Hospital. Eleven cases were spontaneous and seven followed spinal surgery. The infection was located in five cases in the thoracic spine and in 13 cases in the lumbar spine. Only one biopsy was performed during general anaesthesia, the rest under local anaesthesia. No complications were observed. The bioptic material was cultivated immediately beside the patient and incubated for 14 days. The infective organism was isolated in 12 cases (67%). Thus, material obtained through a fine needle was satisfactory for microbiological investigation. A biopsy is crucial for establishing a microbiological diagnosis and thereby enabling prompt adequate treatment.

Adolescent↗
PubMed1998

[Spontaneous and postoperative spondylodiscitis. A material concerning 23 patients].

A retrospective study of 23 patients with spondylodiscitis is reported. Sixteen cases were spontaneous. Five of these were seen in the acute phase with S. aureus grown from the blood. Eleven patients were investigated with CT-guided biopsy of the spine with identification of different microorganisms in eight cases. In four of seven cases of spondylodiscitis after operation for disc herniation coagulase-negative staphyloccoci were grown after CT-guided biopsy. In spontaneous cases pain disappeared and CRP was normalized within a few weeks after treatment with antibiotics, but radiological changes might progress for several months. Antibiotics were given for two to six months, with a mean of 5.1 months in purulent bacterial infections, and all patients were considered cured after this.

Adolescent↗
PubMed1997

[Dorsal cord compression by aspergilloma. Apropos of a case].

Spinal cord compressions are mainly due to Pott disease. We present a rare case. A 31 years old woman presenting a spinal cord compression due to an aspergilloma. Our patient presented also a pulmonary aspergillosis. The spinal compression was due to a contiguous extension of aspergillus to the epidural site. The treatment associated surgery and medical treatment (Ketoconazole), with efficient results.

Abscess↗
PubMed1998

[Propionibacterium acnes infectious endocarditis].

BACKGROUND: Propionibacterium acnes, a Gram positive microaerophilic bacteria is considered to have a low level of virulence. Nevertheless, it can be associated with infective endocarditis. We report 2 cases and a review of the literature. CASE REPORTS: The first man developed an acute prosthetic valve infective endocarditis and died. The second case was also a prosthetic valve infective endocarditis in a patient who developed infectious spondylitis. DISCUSSION: P. acnes is an uncommon causal agent in infective endocarditis and appears to have a predilectio for prosthetic valves. A prior history of skin infection is rare. P. acnes grow quite slowly, often requiring 7 to 14 days for identification. All isolates of P. acnes from blood or valve do not necessarily mean contamination.

Discitis↗