Presentation
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]
Entire Body System
- 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]
We present the case of a 67-year-old white patient with type 2 diabetes who went to Hospital for high fever, back pain, and worsening of known infected ulcers in the left foot. [edmcasereports.com]
- 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]
Respiratoric
- Chronic Cough
We report a 4-year-old boy with chronic cough and kyphosis, who had a fungal vertebral osteomyelitis and Acinetobacter spp. paravertebral soft tissue infection related to X-linked chronic granulomatous disease. [ncbi.nlm.nih.gov]
Liver, Gall & Pancreas
- Hepatomegaly
In differential diagnosis of vertebral osteomyelitis, consumption of unpasteurized cheese, dealing with husbandry, sweating, arthralgia, hepatomegaly, elevated alanine transaminase, and lumbar involvement in magnetic resonance imaging were found to be [ncbi.nlm.nih.gov]
Musculoskeletal
- Back Pain
Despite persisting back pain, no recurrence of infection was seen at 3 years of follow-up. Lemierre syndrome and an extensive thoracolumbosacral vertebral osteomyelitis are rare but serious infections. [ncbi.nlm.nih.gov]
- Low Back Pain
A 65-year-old man presented with low back pain and fever. He had a history of psoriasis vulgaris treated with adalimumab. The patient reported drinking adequate amounts of well water daily. [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]
Workup
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]
Microbiology
- Scedosporium
Fungal vertebral osteomyelitis due to Scedosporium apiospermum (S. apiospermum) is extremely rare. [ncbi.nlm.nih.gov]
- Mycobacterium Chelonae
Mycobacterium chelonae is a rapidly growing mycobacterium (RGM) in Runyon group IV. This group includes all other nontuberculous mycobacterium (NTM) except the mycobacterium tuberculosis complex. [ncbi.nlm.nih.gov]
Treatment
After 3 months of antibiotic treatment, all enhanced lesions were diminished. An intramedullary spinal cord abscess is a rare but important complication of vertebral osteomyelitis, and it requires immediate treatment. [ncbi.nlm.nih.gov]
The trial was designed to assess non-inferiority between the two treatment regimens using a 10% margin. Patients for whom treatment duration was longer than the randomized time period were considered to be treatment failures. [the-rheumatologist.org]
Prognosis
BACKGROUND: Hematogenous vertebral osteomyelitis (HVO) has a generally favorable prognosis if appropriate treatment is initiated in its early phase; however, some intractable cases with HVO can develop neurological impairment as well as spinal deformity [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]
Vertebral osteomyelitis often attacks two vertebrae and the corresponding intervertebral disk, causing narrowing of the disc space between the vertebrae. [5] The prognosis for the disease is dependent on where the infection is concentrated in the spine [en.wikipedia.org]
Positron-emission tomographic (PET) scanning with 18F-fluorodeoxyglucose has a diagnostic accuracy similar to that of MRI and may be a better choice when the patient has metallic implants 1 Vertebral Osteomyelitis (V0): Vertebral Osteomyelitis (V0) Prognosis [authorstream.com]
Etiology
Abstract Vertebral osteomyelitis is known to occur in chronic granulomatous disease, a phagocytic disorder and the etiology is usually a fungus. [ncbi.nlm.nih.gov]
Epidemiology
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]
Pathophysiology
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]
Prevention
Prompt diagnosis of MAC vertebral osteomyelitis is challenging, but necessary to prevent serious morbidity or mortality. [ncbi.nlm.nih.gov]
“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]
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]