spinal infection

Etiology

• Staphylococcus aureus (most common)
• risk factors
  • indwelling venous catheter
  • AV fisutla
  • diabetes mellitus
  • hemodialysis
  • intravenous drug abuse
  • immunosuppression
  • malignancy

Epidemiology

• uncommon
• more common in elderly

Pathology

• generally occurs via hematogenous spread from another site, frequently bacterial endocarditis
• intervertebral disc infection (75%)
  • generally accompanied by vertebral osteomyelitis
• isolated vertebral osteomyelitis

Clinical manifestations

• back pain (most common)
  • spinal tenderness variable
• fever (50%)
• straight leg raising may be positive
• neurologic signs < 1/3 of cases
  • lower extremity muscle weakness
  • sensory impairment

Laboratory

• complete blood count
  • leukocytosis (50-60%)
• erythrocyte sedimentation rate & serum C-reactive protein increased in > 90% of patients
• blood cultures

Radiology

• plain films not diagnostic

Complications

• abscess requiring drainage &/or prolonged antibiotic therapy
• spinal cord infection
  • paralysis

Management

• see vertebral osteomyelitis

More general terms

• infection (infectious disease)

More specific terms

• vertebral osteomyelitis