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At least 145 records · Page 8Linked to original sources
PubMed1986

Discitis due to Clostridium perfringens.

Diagnosis of the infectious process of the intervertebral disc is often delayed due to the lack of specifity of the clinical picture. This delay in diagnosis and consequently in treatment can lead to severe neurologic sequela. In these cases, punction biopsy of the intervertebral disc is of special value. The authors found no mention in the literature concerning Chlostridium perfringens discitis verified by aspiration and fluid culture extracted by intervertebral disc puncture.

Adult↗
PubMedDate not supplied

Magnetic resonance imaging in the diagnosis of childhood discitis.

Diagnosis of disc space infection in childhood is often delayed and is usually made on the basis of multiple roentgenographic, laboratory, and nuclear imaging studies. Four cases of septic discitis in children are described. Special emphasis is placed on the diagnostic findings with magnetic resonance imaging. Magnetic resonance sensitivity for this entity and its role in comparison with other imaging modalities are discussed.

Child, Preschool↗
PubMedDate not supplied

Anatomic basis for the pathogenesis and radiologic features of vertebral osteomyelitis and its differentiation from childhood discitis. A microarteriographic investigation.

Microarteriography has demonstrated the anatomy which explains the pathogenesis and radiologic features of adult vertebral osteomyelitis and of childhood discitis. Infarction is caused in the metaphysis by a septic embolus. The intraosseous arteries in children are anastomotic and a small portion of bone is destroyed. In adults a larger portion of bone is destroyed because the intraosseous arteries are end-arteries and septic thrombosis spreads into peripheral intraosseous arteries. The disc is avascular at all ages and is attacked by infection equally. The trans-equatorial spread of osteomyelitis occurs via an artery which is first described here. It joins the metaphyseal anastomoses of the same vertebral body in the midline.

Adult↗
PubMed1993

Lymph and blood supply of the human intervertebral disc. Cadaver study of correlations to discitis.

Immunohistochemical (antibodies against laminin) and histochemical methods (Ulex europaeus lectin, 5'-nucleotidase activity) were used to describe the vascular pattern of human intervertebral discs and the surrounding tissue at different ages. Blood and lymph vessels were found in the connective tissue outside the annulus in all age groups. In the annulus blood vessels and lymphatics were detected up to 20 years of age, in the cartilage end-plate blood vessels appeared up to 7 years of age (cartilage canals). In the nucleus pulposus neither blood nor lymph vessels could be seen at any age. The occurrence of blood and lymph vessels in growing intervertebral discs help us to understand childhood discitis without simultaneous affection of the vertebral body.

Adolescent↗
PubMed1988

Aspergillus discitis. Report of two cases and review of the literature.

Aspergillus discitis is a rare disease that usually occurs in immunocompromised hosts. In the one case reported in the orthopedic literature surgical debridement was required. Two additional cases, which occurred in intravenous drug abusers, are reported here. One case is unique in the orthopedic literature in that eradication of the disease occurred with chemotherapy alone.

Adult↗
PubMed1987

Postoperative discitis. Diagnosis and management.

Postoperative discitis (POD) continues to be a diagnostic challenge and its management remains variable. This article raises the following questions and presents new observations. What is the current role of the CT scan in POD? Is a uniform pathogen involved and is there a basis for the duration of intravenous antibiotics? What is the expected long-term functional result? In a retrospective analysis of 12 consecutive patients with POD followed for an average of 29 months (17-42 months), the CT scan was extremely sensitive in showing a pathogen was present. The CT scan was misread in over one-third of the cases. Gram-positive cocci were the only organisms cultured (10 of 13 cultures, 8 of 12 patients). The erythrocyte sedimentation rate (ESR) invariably fell predictably to normal within 90 days when patients were treated with IV antibiotics for more than 40 days. Most patients were clinically improved and subjectively better at follow-up examination. No correlation existed between the patient's subjective result and preexisting medical conditions, the type of antibiotic, or the length of treatment, the ESR, or the follow-up roentgenograms.

Adult↗
PubMed1979

[Discitis in small children (author's transl)].

Discitis was diagnosed in 5 children under 3 years of age, the initial clinical manifestations being difficulty in walking and abdominal pains in one case. Diagnosis was not made before periods varying from 8 days to 3 months, and no etiological basis for the disease was discovered. Pinching of the disc was always present in the first radiographic image, and the vertebral plate was ill-defined in 3 cases. Repeat radiological examinations were carried out in 3 children after 6 months, 2 and 5 years respectively. There was partial restauration of the disc space in 2 cases; the last one presented signs of late collapse after early recuperation. Early perilesional bone sclerosis was noted in 2 cases, while it was posterior and late in one child. There were no sequelae (fusion, vertebra plana, scoliosis). Two investigations are essential if a disc lesion is suspected: -- radiography of the spinal column, even if there are no disturbances in walking or abdominal pains. -- scintigraphy with technitium 99, which is the only means of establishing an early diagnosis.

Child, Preschool↗
PubMed1984

Discitis as a cause of abdominal pain in children.

The purpose of this study is to draw attention to inflammatory disease of lumbar intervertebral discs in children as a source of referred abdominal pain. For three children presenting with abdominal pain the eventual diagnosis was discitis of the lumbar spine. Failure to examine the patient's backs at the initial examinations resulted in a delay in diagnosis ranging from 66 to 2 days. Treatment with antibiotics and spinal jacket was effective in all cases.

Abdomen↗
PubMedDate not supplied

Intervertebral discitis in children and adolescents.

In 29 children wih symptoms and signs as well as laboratory and radiographic findings consistent with intervertebral discitis, the syndrome appeared to be a manifestation of both infectious and noninfectious inflammatory processes. When systemic sepsis is present, antibiotic therapy is indicated. In the absence of fever and leukocytosis, plaster cast immobilization should suffice. Craig needle aspiration and/or open biopsy are not routinely required, but should be reserved for those patients who fail to respond to routine treatment in whom tuberculosis is suspected.

Adolescent↗
PubMed2004

The etiologic diagnosis of infectious discitis is improved by amplification-based DNA analysis.

OBJECTIVE: Blood cultures and cultures of disc material are required to identify and treat bacterial agents responsible for septic spondylodiscitis, but these methods have limited sensitivities. We undertook this study to compare nonculture amplification-based DNA analysis with conventional culture of disc aspirate. METHODS: Nineteen patients with spondylodiscitis, including 11 with a history of spinal surgery, presented with negative blood cultures and underwent percutaneous disc or epidural abscess puncture for bacterial diagnosis. Amplification by polymerase chain reaction was performed on 16S ribosomal DNA universal target genes and femA staphylococci-specific target genes in all patients, and on the upstream p34 mycobacterial gene in 1 patient. Species identification relied on amplicon sequencing and comparison with templates from GenBank. Amplification of the femA gene led to subsequent testing for methicillin resistance by amplification of the mecA gene. Further assessment using a staphylococci- and methicillin resistance-specific DNA array was performed on 3 samples. RESULTS: Microbiologic and molecular assays identified the causative organism in 14 of 19 patients (74%) and 19 of 19 patients (100%), respectively. In culture-positive patients, DNA-based and microbiologic results were highly correlated. Five agents (Staphylococcus simulans, Staphylococcus sciuri, Brucella species, Actinomyces israelii, and Mycobacterium tuberculosis complex) were identified only by DNA-based methods. In 1 sample, Corynebacterium jeikeium and coagulase-negative Staphylococcus were both cultured, whereas DNA analysis identified only Staphylococcus hominis. CONCLUSION: DNA-based methods are highly sensitive and specific. They can usefully complement standard microbiologic methods for identifying the cause of infectious spondylodiscitis and contribute to species-specific therapeutic orientation in patients with negative blood and disc aspirate cultures.

Adult↗
PubMed1989

A destructive discovertebral lesion: septic discitis, ankylosing spondylitis, or rheumatoid arthritis?

A 41-year-old male with a 20-year history of classical ankylosing spondylitis, psoriasis and seropositive, nodular erosive rheumatoid arthritis presented with a 12-month history of thoracolumbar junction pain following minor trauma. A pseudoarthrosis was noted at the T11/12 level on plain radiographs and tomograms. A gallium scan showed no increased isotope uptake, and a computed tomogram (CT) revealed no evidence of a paraspinal collection. Conservative management including cast immobilisation and local radiotherapy was ineffective, and spinal fusion was required. A typical Andersson lesion was found at operation. The diagnostic and therapeutic problems of such discovertebral lesions are discussed.

Adult↗
PubMed2004

Case report: Pseudomonas aeruginosa-related intervertebral discitis in a young boy with medulloblastoma.

We report a case of a 15-year-old boy with desmoplastic medulloblastoma of the posterior fossa (T3M3, according to Chang classification) incompletely resected, with leptomeningeal and nodular spread in the posterior fossa and in the cervical and thoracic tracts of the spine, treated with sequential high dose iv chemotherapy and with hyperfractionated cranio-spinal radiotherapy. While on maintenance chemotherapy, the boy developed fever and septic status caused by Pseudomonas aeruginosa, and 1 week later also low back pain. Magnetic resonance imaging (MRI) demonstrated abnormal signal in the fourth ventricle and in the dorso-lumbar tract suggesting medulloblastoma recurrence, so he started with a chemotherapy program. Due to a worsening of back pain, a second MRI of the spine was performed that showed a spondilodiscitis of T11-T12 and L1-L2 discs. The histological and cultural examination of a fine-needle biopsy of the L1-L2 disc revealed the presence of P. aeruginosa. So patient was treated with intensive antibiotic therapy with resolution of the infection. Spondilodiscitis is a rare complication in neoplastic patients, maybe due to either immunodeficient status or invasive procedures such as lumbar puncture. This case demonstrates that MRI is a useful method for differentiating between infection and malignancy in the spine, but sometimes it may be difficult to distinguish metastatic tumor from a lesion due to spondilodiscitis. In this case surgicopathological assessment is crucial and mandatory.

Adolescent↗