Magnetic resonance-imaging scans in discitis. Sequential studies in a child who needed operative drainage: a case report.
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A 14-year-old girl with fever and low back pain was diagnosed as having brucellosis and diskitis. Treatment with doxycycline and gentamicin had no effect nor was there any improvement when the treatment was changed to doxycycline and rifampicin. With cessation of this treatment and administration of cloxacillin fever was reduced and the back pain disappeared. After 12 days of i.v. cloxacillin, she was released from hospital with instructions to continue cloxacillin orally for another 4 weeks. We conclude that when a patient is suffering from brucellosis and diskitis and does not respond to the usual anti-brucellosis treatment, an anti-staphylococcal preparation should be added.
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A 48-year-old man complained of severe neck pain. T1-weighted magnetic resonance imaging (MRI) after intravenous injection of Gadolinium disclosed homogeneously enhanced masses in the retropharyngeal soft tissue, in the inter-vertebral disc space between C3 and C4, and in the spinal epidural space behind the vertebral body. The symptoms of the patient improved smoothly after intravenous injection of antibiotics without surgical procedure. In this case, MRI was very important and useful in the prompt diagnosis of the disease.
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