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Discitis


Presentation

  • This comparative study suggests that age and clinical presentation distinguish most patients with discitis from those with vertebral osteomyelitis.[pediatrics.aappublications.org]
  • Eventually the pain became so severe that he presented to the emergency room two months after undergoing the LP. On presentation he had a leukocytosis (white blood count 20.7) and mildly elevated erythrocyte sedimentation rate (37).[n.neurology.org]
  • Seventeen patients presented two comorbidities and one patient had three comorbidities.[ncbi.nlm.nih.gov]
  • This kind of spondylodiscitis is most common in patients aged between 30 to 40 years. [6] Characteristics/Clinical Presentation The symptoms are non-specific, diffuse [2] and treacherous [10].[physio-pedia.com]
  • […] abdominosacrocolpopexy. ( 25117721 ) Tymchak ZA...Fourney DR 2015 39 Postoperative initial single fungal discitis progressively spreading to adjacent multiple segments after lumbar discectomy. ( 25436471 ) Zou MX...Wang B 2015 40 Peptostreptococcus endocarditis presenting[malacards.org]
Inflammation
  • In case of concomitant inflammation of one or more vertebrae (in such cases usually involving the areas adjacent to the intervertebral disc spaces) [1] the condition is called spondylodiscitis.[en.wikipedia.org]
  • Provides a reliable evidence for the absence of osseous inflammation [10] Outcome Measures Visual Analogue Scale (VAS): [2] [4] [6] [3] - to evaluate therapeutic effects - for assessment of pain.[physio-pedia.com]
  • Discitis is a rare type of spinal inflammation that often occurs together with osteomyelitis, an infection that affects the bones and bone marrow. It most commonly affects the lumbar region, but may also affect the cervical and thoracic spine.[docdoc.com.sg]
Intravenous Drugs
  • Its risk factors include: Autoimmune disorders Weakened immune system The use of intravenous drugs, which can either be due to IV drug abuse or IV needle contamination Age - Discitis is more common in children under ten years old Diseases that compromise[docdoc.com.sg]
  • This finding has not been replicated in our series with only one case, probably related to the low intravenous drug user population.[ncbi.nlm.nih.gov]
Weakness
  • Immobilization lead to weakness of the trunk and lower extremity muscles and will contribute to complications. Secondary problems because of immobilization and musculoskeletal problems should be looked after and prevented.[physio-pedia.com]
  • Bed rest, which may be necessary for some patients Lifestyle changes, including changes to the patient’s daily activities Gentle exercises for the unaffected parts of the body to prevent generalised body weakness If the condition fails to improve, more[docdoc.com.sg]
Swelling
  • What is Discitis: Causes, Symptoms, Diagnosis, and Treatment Definition and Overview Discitis is a medical condition where swelling occurs in spaces between the discs in the vertebrae, causing abnormal pressure on the discs and pain.[docdoc.com.sg]
Malaise
  • Presenting symptoms include low-back pain, tenderness, spasm, fever, and malaise, typically several weeks to months post-procedure. Laboratory studies may show elevated inflammatory markers.[n.neurology.org]
Pneumonia
  • Neutropenic sepsis infection such as pneumonia, urinary tract infection, meningitis, encephalitis, discitis, endocarditis, osteomyelitis, or infection of a...[evidence.nhs.uk]
  • Most of the cases are associated with systemic infections, such as urinary tract infection, soft-tissue infection, and pneumonia. Such infections are most commonly caused by staphylococcus aureus, E.coli, and Proteus bacterial species.[docdoc.com.sg]
Abdominal Pain
  • Key Symptoms Discitis causes the following symptoms: Pain in certain parts of the spine Pain in the lower and upper back Changes in posture Back stiffness Difficulty performing regular tasks Fever Abdominal pain The pain caused by discitis can be quite[docdoc.com.sg]
  • pain Incontinence may be a presenting feature Loss of lumbar lordosis and lower back movement Compared with adults, children are less likely to have comorbidities and neurological deficits are uncommon [1] The severity of the infection does not always[physio-pedia.com]
Arthritis
  • Low back pain : Topical Review In September 2003, the Arthritis Research Campaign (now known as Arthritis Research UK), published a Topical Review entitled 'Low Back Pain'. Low back pain is a common musculoskeletal complaint and...[evidence.nhs.uk]
  • […] of Candida Discitis. ( 28985261 ) Waldon K...Chattopadhyay T 2018 7 Treatment of lumbar discitis using silicon nitride spinal spacers: A case series and literature review. ( 29462728 ) Rambo WM 2018 8 Discitis caused by rat bite fever in a rheumatoid arthritis[malacards.org]
Neck Pain
  • In post-operative situations, the symptoms occur within a week and result in severe low back pain or neck pain (depending on the surgical location).[en.wikipedia.org]
  • Back or neck pain [1] [10] Constant pain, more worse at night [2] [6] [11] Radicular pain radiating to the chest or abdomen Fever (less common in patients with tuberculous spondylodiscitis, 1/2 of the cases) [1] [10] [4] Spinal deformities, predominantly[physio-pedia.com]
Suggestibility
  • This comparative study suggests that age and clinical presentation distinguish most patients with discitis from those with vertebral osteomyelitis.[pediatrics.aappublications.org]
  • […] of the vertebrae with subsequent kyphosis. [2] The cause may be aseptic. [3] Diagnosis [ edit ] An infected disc at the level of C5 C6 causing neurological symptoms Diagnosis is usually apparent on MRI although plain X-rays and CT examinations can be suggestive[en.wikipedia.org]
Focal Neurologic Deficit
  • Conclusions: While back pain is a common symptom following LP, physicians should also be aware of discitis as a rare, but potential, complication in patients with persistent pain even in the absence of focal neurological deficits and laboratory abnormalities[n.neurology.org]
Meningism
  • Neutropenic sepsis infection such as pneumonia, urinary tract infection, meningitis, encephalitis, discitis, endocarditis, osteomyelitis, or infection of a...[evidence.nhs.uk]

Workup

Staphylococcus Aureus
  • Such infections are most commonly caused by staphylococcus aureus, E.coli, and Proteus bacterial species.[docdoc.com.sg]
  • Increasing frequency of vertebral osteomyelitis following Staphylococcus aureus bacteraemia in Denmark 1980–1990. J Infect. 1997; 34 :113–118. doi: 10.1016/S0163-4453(97)92395-1. [ PubMed ] [ CrossRef ] [ Google Scholar ] 5.[ncbi.nlm.nih.gov]
  • aureus. ( 27918144 ) Bostian PA...Emery SE 2017 16 The role of minimally invasive spine surgery in the management of pyogenic spinal discitis. ( 28250635 ) Turel MK...Deutsch H 2017 17 [Retropharyngeal abscess with cervical discitis and vertebral osteomyelitis[malacards.org]
Clostridium Perfringens
  • perfringens bacteraemia. ( 28747416 ) Yong CH...Lam M 2017 19 Presence of Modic type 1 change increases risk of postoperative pyogenic discitis following decompression surgery for lumbar canal stenosis. ( 28802716 ) Ninomiya K...Ishii K 2017 20 Yield[malacards.org]

Treatment

  • Patients who undergo antibiotic therapy for discitis often require a standard treatment period of 6 to 8 weeks.[docdoc.com.sg]
  • Treatment [ edit ] Treatment usually includes antibiotics, and reducing the mobility of the affected region, either with a back brace or a plaster cast. Without treatment, the patient may form an abscess which may need to be surgically corrected.[en.wikipedia.org]
  • Surgical treatment is superior to conservative treatment in a short time, while conservative treatment can achieve long-term satisfactory curative effects.[physio-pedia.com]
  • Fusion to Manage Postdiscectomy Discitis in Lumbar Spine. ( 30308339 ) Chang CW...Chen WJ 2019 3 Community acquired Stenotrophomonas maltophilia discitis: Diagnosis aided by shotgun metagenomic sequencing. ( 30684744 ) Wang G...Yang S 2019 4 Endoscopic Treatment[malacards.org]
  • . * Rapid diagnosis and treatment are essential to preserve spinal stability and neurological function. * Discitis is usually treated nonoperatively with antibiotics.[journals.lww.com]

Prognosis

  • The prognosis for patients suffering from discitis is heavily influenced by how early the condition is diagnosed and treated.[docdoc.com.sg]
  • Prognosis seems to be good with conservative treatment including NSAID’S, physiotherapy (exercises), and a corset. Extension:RSS -- Error: Not a valid URL: Feed goes here!![physio-pedia.com]

Etiology

  • Etiology and ecology. Arch Intern Med. 1962; 110 :847–855. doi: 10.1001/archinte.1962.03620240029006. [ CrossRef ] [ Google Scholar ] 2. McHenry MC, Easley KA, Locker GA.[ncbi.nlm.nih.gov]
  • The difference between the two types, is that the intervertebral disc and the joint space are preserved longer in the tuberculous spondylodiscitis. [8] Epidemiology /Etiology According to scarce researches, the incidence of spondylodiscitis is 2.4/100,000[physio-pedia.com]

Epidemiology

  • Search Strategy Keywords : Spondylodiscitis Diagnosis / Therapy / Epidemiology / Rehabilitation / Rehabilitation / Examination / Symptoms / Characteristics / Clinical Search engines : Pubmed Web of knowledge PEDro Definition/Description Spondylodiscitis[physio-pedia.com]
  • Introduction and epidemiology The optimal management of pyogenic discitis is not agreed on. Little is known about the risk factors, clinical features, diagnosis, optimal treatment, or management outcomes of adults with spontaneous discitis.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • ., Intervertebral Disc: Anatomy-Physiology-Pathophysiology-Treatment, Department of Anesthesiology and Pain Management, World Institute of Pain, 2008 (level of evidence 2A) 10.00 10.01 10.02 10.03 10.04 10.05 10.06 10.07 10.08 10.09 10.10 10.11 10.12[physio-pedia.com]

Prevention

  • This is why patients with discitis should be treated immediately to prevent serious complications. Causes of Condition Discitis cases are classified as either spontaneous or post-operative.[docdoc.com.sg]
  • Keeping the hamstrings flexible is important for pain control as well as in prevention of spinal pain flare-ups.[physio-pedia.com]

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