1/144. fluconazole therapy in candida albicans spondylodiscitis.A case of candida albicans spondylodiscitis in a 20-year-old female liver transplant recipient is reported. The patient was successfully treated with sequential therapy with liposomal amphotericin b and fluconazole. A review of the literature showed 10 cases of candida albicans spondylodiscitis successfully treated either with fluconazole alone or a sequential therapy with amphotericin b and fluconazole. If long-term amphotericin b therapy is not feasible, a prolonged course of fluconazole in a daily dose of 200-400 mg may be considered as an alternative.- - - - - - - - - - ranking = 1keywords = discitis, spondylodiscitis (Clic here for more details about this article) |
2/144. Cervical spondylodiscitis after removal of a fishbone. A case report.STUDY DESIGN: A case report of cervical spondylodiscitis after removal of a lodged fishbone. OBJECTIVES: To present a rare case of cervical spondylodiscitis and to inform the readers that a lodged fishbone can give rise to this complication after its removal. SUMMARY OF BACKGROUND DATA: In the literature, only one mention of this complication was found. methods: The literature, clinical presentation, technical examinations, and treatment are reviewed. RESULTS: Prolonged antibiotic treatment and immobilization of the cervical spine resulted in a cure of the spondylodiscitis. CONCLUSIONS: After removal of a lodged fishbone, a cervical spondylodiscitis is possible, but this is a very rare complication. In this patient, conservative treatment resulted in a cure of the infection. Successive magnetic resonance imaging investigations showed the extent of the destruction of the vertebral bodies and disc very well, as well as the curation of the spondylodiscitis after 5 months.- - - - - - - - - - ranking = 1.5keywords = discitis, spondylodiscitis (Clic here for more details about this article) |
3/144. Brucellar spinal epidural abscess.Spinal epidural abscesses account for approximately one of every 10, 000 admissions to tertiary hospitals. The midthoracic vertebrae are the most frequently affected, whilst the cervical spine is involved in fewer patients. staphylococcus aureus is identified as the cause in most cases of epidural abscess; other bacteria responsible include gram-negative bacteria, streptococcus species and brucella species. We report the case of a patient with cervical spondylodiscitis at level C4-C5 and an epidural abscess which was compressing the spinal cord and the retropharyngeal space. The previous symptoms of brucellosis were atypical. We discuss the clinical manifestations, diagnosis, treatment and prognosis of the case.- - - - - - - - - - ranking = 0.16666666666667keywords = discitis, spondylodiscitis (Clic here for more details about this article) |
4/144. Anterior disc protrusion as a cause for abdominal symptoms in childhood discitis. A case report.STUDY DESIGN: A case report on infectious spondylitis in a child who reported abdominal pain and whose magnetic resonance image revealed anterior herniation of disc space contents. OBJECTIVES: To correlate the direction of disc protrusion in infectious spondylitis with clinical manifestations. SUMMARY OF BACKGROUND DATA: Previous studies have correlated posterior protrusion of disc space contents in infectious spondylitis with a clinical presentation of back pain, paravertebral muscle spasm, hamstrings tightness, and radiculopathy. None has connected anterior herniation of disc phlegmon with abdominal pain. methods: In addition to plain radiography and bone scintigraphy, magnetic resonance imaging was used to confirm the diagnosis of infectious spondylitis in a 6-year-old child with abdominal pain. Regular review for 1 year included repeat magnetic resonance imaging at 3 months. RESULTS: Initial magnetic resonance imaging revealed characteristic changes associated with infectious spondylitis throughout the L5-S1 vertebra-disc-vertebra unit and anterior protrusion of the disc material and phlegmon. magnetic resonance imaging at follow-up examination 3 months later demonstrated complete resolution of the disc herniation. CONCLUSION: Future magnetic resonance imaging studies should correlate direction of disc herniation with age and symptomatology to validate or improve classifications of infectious spondylitis, which presently include only the last two parameters.- - - - - - - - - - ranking = 0.48618961335605keywords = discitis (Clic here for more details about this article) |
5/144. Spondylodiscitis caused by viridans streptococci: three cases and a review of the literature.Three cases of spondylodiscitis caused by viridans streptococci were observed within the course of 1 month. Although streptococci have been reported as the third most frequent cause of spondylodiscitis after staphylococci and gram-negative bacteria, alpha-haemolytic streptococci are rarely seen. The three patients presented with symptoms of low back pain; they felt well and did not have a fever or chills. Laboratory examinations revealed inflammation. Further examinations such as scintigraphy, computed tomography or magnetic resonance imaging were done. Bacteriological diagnosis was established by blood cultures in two cases and by needle biopsy of the disco-vertebral space in one. In one patient endocarditis was also documented. Because the prevalence of endocarditis was found to be higher in our cases of spondylodiscitis due to streptococcus viridans than for other bacteria, the exclusion of this diagnosis must be pursued aggressively. These observations lead us to question if the spectrum of bacteria causing spondylodiscitis is undergoing a change. an aetiological agent could be isolated in 1168 patients (85.4%): in 48% a staphylococcus, in 28% a gram-negative bacterium and in only 10% a streptococcus. There were two cases of viridans streptococci (0.2%). These two cases together with other single case reports [14-22] account for 15 cases of spondylodiscitis due to alpha-haemolytic streptococci. Differentiation of the organisms to the species level was accomplished in six cases: S. mitis (3), S. sanguis (2) and S. anginosus (1). Although a multitude of organisms, bacterial as well as fungal, causing spondylodiscitis has been reported in recent years, almost all were single cases [23-42]. The unusual observation of three cases of spondylodiscitis due to alpha-haemolytic streptococci within 1 month prompted us to review the clinical and laboratory findings and to compare these cases with those caused by staphylococcus aureus.- - - - - - - - - - ranking = 1.6528562800227keywords = discitis, spondylodiscitis (Clic here for more details about this article) |
6/144. Spontaneous spondylodiscitis caused by klebsiella pneumoniae.A rare case of spontaneous spondylodiscitis caused by klebsiella pneumoniae in a 55-year-old man who presented with thoracolumbar pain is described. Increased erythrocyte sedimentation rate and c-reactive protein level were pertinent laboratory findings. Computed tomography revealed a paravertebral mass and destruction of the 10th and 11th vertebrae. magnetic resonance imaging (MRI) showed spondylodiscitis in the same area. culture of a biopsy sample from the mass grew klebsiella pneumoniae, while histological examination confirmed the inflammation. A combination of ceftazidime, amikacin and ciprofloxacin resulted in disappearance of the pain. Two months later, MRI showed substantial improvement of the lesions.- - - - - - - - - - ranking = 1keywords = discitis, spondylodiscitis (Clic here for more details about this article) |
7/144. Aspergillus osteomyelitis after liver transplantation: conservative or surgical treatment?We report on a liver transplant recipient who developed coxarthritis and lumbar spondylodiscitis due to aspergillus flavus. He was treated with high-dose liposomal amphotericin b for 2 months followed by itraconazole. Because of intractable pain and severe, irreversible damage of the left hip, a Girdlestone resection was performed. The spondylodiscitis was treated successfully with anti-fungal agents only, which indicates that, in the absence of neurological impairment, good clinical outcome can be achieved without surgery. This case demonstrates that surgical therapy, which is often proclaimed as unavoidable for the treatment of Aspergillus osteomyelitis, should be considered in particular in the case of intolerable pain due to irreversible joint damage or involvement of vital organs.- - - - - - - - - - ranking = 0.33333333333333keywords = discitis, spondylodiscitis (Clic here for more details about this article) |
8/144. psoas abscess secondary to discitis: a case report of conservative management.We report a case of secondary psoas abscess in a 37-year-old man with a 3-week history of severe low backache managed conservatively without surgical drainage. Apart from bilaterally restricted straight leg raising (<70 degrees), his neurologic examination was within normal limits. magnetic resonance imaging showed discitis of the L3-L4 space and a left-sided secondary psoas abscess. Aspiration biopsy of the abscess material under radiologic control isolated staphylococcus aureus, which responded to appropriate antibiotic therapy with complete resolution. A high index of suspicion is necessary for diagnosis of psoas abscess, which should be considered in patients with pyrexia and backache with a neurologic examination that is otherwise normal. We discuss the recommendations for surgical and nonsurgical approaches.- - - - - - - - - - ranking = 0.60773701669506keywords = discitis (Clic here for more details about this article) |
9/144. Spondylodiscitis associated with bacteraemia due to coagulase-negative staphylococci.Three cases are reported of spondylodiscitis caused by coagulase-negative staphylococci in patients without osteosynthetic material. All three patients had bacteraemia associated with an infected intravascular device left in place. On the basis of this observation, it is concluded that such devices should be removed promptly in cases of prolonged or relapsing bacteraemia. Furthermore, spondylodiscitis should be suspected in patients with back pain after bacteraemia caused by coagulase-negative staphylococci.- - - - - - - - - - ranking = 0.81952294668939keywords = discitis, spondylodiscitis (Clic here for more details about this article) |
10/144. Spondylodiscitis and epidural abscess due to candida albicans.A 32-year-old woman, addicted to heroin, presented with a dorsal spondylodiscitis due to candida albicans associated with epidural abscess. Antimycotic treatment was successful, and no neurosurgical decompression was necessary. To our knowledge, this is the first case of documented epidural involvement in candidal spondylodiscitis. The diagnosis of candidal spondylodiscitis should be considered in cases of para- or tetraplegia occurring in intravenous drug abusers.- - - - - - - - - - ranking = 0.98618961335605keywords = discitis, spondylodiscitis (Clic here for more details about this article) |
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