This report presents a case of thoracic vertebral osteomyelitis with epidural abscesses due to A. nidulans in a 40-year-old immunocompetent female who presented with back pain, numbness and weakness of both lower limbs. [ncbi.nlm.nih.gov]

• Pain

  Case 2 is a 68-year-old woman who presented with upper back pain. Spine MRI revealed multiple lesions at T9-T12, L2, L4, and L5. Her back pain worsened, and repeated MRI revealed extensive bone lesions. [ncbi.nlm.nih.gov]

• Fever

  Fever subsided soon after surgery and the patient continued antibiotics and remained free of fever at a 1-year follow-up. It can be challenging to diagnose vertebral osteomyelitis below injury levels in SCI patients. [ncbi.nlm.nih.gov]

• Malaise

  If any constitutional findings (eg, fever, malaise, weight loss) persist or if large areas of bone are destroyed, necrotic tissue is debrided surgically. [merckmanuals.com]

  In addition, there may be neurologic findings with radicular, meningeal or spinal-cord involvement. 1-3 The patient also may present with general fatigue, malaise and weight loss, and the back pain may be acute or chronic in nature. [dynamicchiropractic.com]

  All three cases presented with fever, back pain, general malaise and weight loss for at least 4 weeks. Diagnosis was established by culture of a spinal biopsy and/or positive blood cultures together with radiological findings. [jmm.microbiologyresearch.org]

  In these cases, symptoms were nonspecific, including back pain, fevers, productive cough, malaise, weight loss, and weakness. [journals.lww.com]

• Asymptomatic

  The patient was asymptomatic and not a surgical candidate, and was treated conservatively with a course of antibiotics. [ncbi.nlm.nih.gov]

  […] spinal shock neurogenic shock associated injuries closed head injuries noncontiguous spinal fractures vertebral artery injury risk factors for vertebral artery injury include atlas fractures facet dislocations most people with unilateral injury remain asymptomatic [orthobullets.com]

  The narrowing can be asymptomatic, but during the aging process most patients will notice radiating pain, weakness and/or numbness. These are secondary complaints caused by compression of the spinal nerves [13]. [physio-pedia.com]

• Pneumonia

  Although pneumococcal urinary antigen test is a useful tool for the diagnosis of pneumococcal pneumonia, we should consider the possibility of pneumococcal infections other than pneumonia or overwhelming bacteremia in immunosuppressive patients when urinary [ncbi.nlm.nih.gov]

  Subsequent lumbar puncture (LP) revealed a CSF leukocyte count of 33 leukocytes/mL (90% neutrophils), protein of 2.36 g/L, and glucose less than 0.1 mmol/L; CSF Gram staining showed Gram-positive cocci and cultures grew S pneumoniae (serogroup 10), sensitive [neurology.org]

• Back Pain

  Case 2 is a 68-year-old woman who presented with upper back pain. Spine MRI revealed multiple lesions at T9-T12, L2, L4, and L5. Her back pain worsened, and repeated MRI revealed extensive bone lesions. [ncbi.nlm.nih.gov]

• Low Back Pain

  We report the first case of vertebral osteomyelitis caused by H. cinaedi in an elderly man with low back pain and fever. [ncbi.nlm.nih.gov]

• Upper Back Pain

  Case 2 is a 68-year-old woman who presented with upper back pain. Spine MRI revealed multiple lesions at T9-T12, L2, L4, and L5. Her back pain worsened, and repeated MRI revealed extensive bone lesions. [ncbi.nlm.nih.gov]

  Case 2 is a 68-year-old woman who presented with upper back pain. Spine MRI revealed multiple lesions at T9–T12, L2, L4, and L5. Her back pain worsened, and repeated MRI revealed extensive bone lesions. [link.springer.com]

• Paravertebral Muscle Spasm

  Vertebral osteomyelitis causes localized back pain and tenderness with paravertebral muscle spasm that is unresponsive to conservative treatment. [merckmanuals.com]

• Bone Disorder

  Autoinflammatory bone disorders with special focus on chronic recurrent multifocal osteomyelitis (CRMO). Pediatr Rheumatol Online J. 2013;11:47. 4) Sharma M, Ferguson PJ. [nanbyou.or.jp]

• Meningism

  This case suggests that Salmonella should be considered as an etiologic pathogen in adult patients with perivertebral infection or meningitis. [ncbi.nlm.nih.gov]

  Bacterial meningitis is a serious and life-threatening disease with a broad spectrum of complications. 1 Vertebral osteomyelitis is a rare complication of bacterial meningitis and has only been described in patients with meningitis due to uncommon pathogens [neurology.org]

  Infection can extend posteriorly, causing epidural or subdural abscesses and even meningitis. Infection can also extend anteriorly and laterally, leading to paravertebral abscesses, mediastinal abscess, and so forth. [errolozdalga.com]

  MRI findings during the antibiotic treatment will be monitored and compared for the differential diagnosis of meningitis. [clinicaltrials.gov]

  In addition, there may be neurologic findings with radicular, meningeal or spinal-cord involvement. 1-3 The patient also may present with general fatigue, malaise and weight loss, and the back pain may be acute or chronic in nature. [dynamicchiropractic.com]

• Confusion

  This is an unusual case of a 68-year-old gentleman who presented to hospital confused and unwell with a methicillin-resistant Staphylococcus aureus bacteraemia. Clinical examination and routine investigations revealed no obvious source of infection. [ncbi.nlm.nih.gov]

  A 51-year-old man with a history of depressive mood disorder and chronic low back pain presented to the emergency room (ER) with a 4-day history of fever and backache followed by confusion. [neurology.org]

  For example, the leg pain of neurogenic claudication can be confused with that of vascular claudication, or poor blood supply to the legs. [precisionneurosurgery.com.au]

  MRI scans do not expose the patient to radiation and are highly sensitive to changes in the size and appearance of the intervertebral discs; however, findings on the MRI scan may be confused with other conditions such as the presence of tumors or bone [en.wikipedia.org]

• Neck Stiffness

  Neurologic examination showed neck stiffness and right-sided facial nerve palsy. Empirical therapy was started with dexamethasone (10 mg) and penicillin (2 million IU). CT scan of the head showed no abnormalities. [neurology.org]

This case demonstrates that early changes on MRI should warrant immediate workup and treatment. Treatment involves at least 6 weeks of parenteral antimicrobial therapy. [ncbi.nlm.nih.gov]

While biopsy is an important part of the diagnostic workup of vertebral osteomyelitis, the microbiological yield was only 40-60% in previous studies [ 7, 16 ], similar to the 64% yield (28/44 bone cultures) in our study. [bmcinfectdis.biomedcentral.com]

If such symptoms are present, further diagnostic workup is immediately warranted. [physio-pedia.com]

• Streptococcus Pneumoniae

  NYMC Faculty Publications Title Pneumococcal Vertebral Osteomyelitis after Epidural Injection: A Rare Event Abstract Streptococcus pneumoniae vertebral infections have rarely been reported. [touroscholar.touro.edu]

This case demonstrates that early changes on MRI should warrant immediate workup and treatment. Treatment involves at least 6 weeks of parenteral antimicrobial therapy. [ncbi.nlm.nih.gov]

Medical imaging techniques for vertebral osteomyelitis are a main focus, and treatment, prognosis, and possible complications also are discussed. [ncbi.nlm.nih.gov]

Treatment and prognosis Not surprisingly, the degree of involvement of the cord and degree of swelling herald a poor prognosis, with many patients not being able to walk and requiring long-term urinary catheterisation. [radiopaedia.org]

About this article Publication history Issue Date 01 October 2000 DOI https://doi.org/10.1038/sj.sc.3101057 Further reading Risk factors and prognosis of vertebral compressive fracture in pyogenic vertebral osteomyelitis Alba Ribera, Maria Labori, Javier [nature.com]

Elevated laboratory values such as erythrocyte sedimentation rate and C-reactive protein suggest inflammatory etiologies. [ncbi.nlm.nih.gov]

Overall, VO in OLT patients was more difficult to diagnose as a result of altered inflammation response and specific microbial epidemiology of causal microorganisms. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. [ncbi.nlm.nih.gov]

If clinical or epidemiological evidence points to the need, blood cultures and serological tests for Brucella or fungi may be indicated. [ahcmedia.com]

Epidemiology 1 to 2.4 cases per 100,000 people ( Zimmerli 2010 ) More common in males with M:F of 3:1 Rate is also increasing due to increased number of spinal procedures Typically affects adults, with most cases occurring in patients over 50 years old [coreem.net]

Contents References 125 Diagnosis of Circulatory Disorders 129 52 Pathophysiology 130 54 Distinctive Forms of Osteonecrosis 132 References 141 Neoplastic Bone Diseases 143 62 Pathophysiology 144 63 Scintigraphy of Primary Bone Tumors 154 64 Scintigraphy [books.google.com]

[…] cervical spine risk factors include IV drug abuse diabetes recent systemic infection (UTI, pneumonia) obesity malignancy immunodeficiency or immunosuppressive medications malnutrition (serum albumin < 3 g/dL indicative of malnutrition) trauma smoking Pathophysiology [orthobullets.com]

Pathophysiology • Approximately 95% of pyogenic spinal infections involve the vertebral body, and only 5% involve the posterior elements of the spine. [de.slideshare.net]

Neuroradiol Scan 2016; 06(03): 215-238 DOI: 10.1055/s-0042-109937 © Georg Thieme Verlag KG Stuttgart · New York Spinal neuroarthropathy: pathophysiology, clinical and imaging features, and differential diagnosis Weitere Informationen Publikationsverlauf [thieme-connect.com]

Prompt diagnosis of MAC vertebral osteomyelitis is challenging, but necessary to prevent serious morbidity or mortality. [ncbi.nlm.nih.gov]

Osteomyelitis surgery prevents the infection from spreading further or getting so bad that amputation is the only remaining option. Preventing Osteomyelitis The best way to prevent osteomyelitis is to keep things clean. [webmd.com]

“Early diagnosis and appropriate management can prevent disability, so a high index of suspicion and early ID consultation are central to a good outcome.” [idsociety.org]