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Spondylodiscitis is the most common complication of sepsis or local infection, usually in the form of an abscess. The main causative organisms are staphylococci, but potential organisms include a large number of bacteria, fungi, zoonoses. Spondylodiscitis frequently develops in immunocompromised individuals, such as by a cancer, infection, or by immunosuppressive drugs used for organ transplantations.
Diagnosis
The main methods to diagnose a spondylodiscitis are magnetic resonance imaging (MRI), biopsy and microbiological tests such as PCR to determine an infectious cause.
Treatment
Approximately 90% of cases can be treated conservatively. In the absence of spinal cord/nerve root compression and lack of data on instability of the inflamed segment, conservative treatment with:
Antibiotics - empirical treatment should start AFTER biopsy material for microbiological testing is obtained (PMID 27082590). The following empirical treatment may be administered for a total of 6 weeks (PMID 26872859): - Ceftriaxone 2x2g and Clindamycin 3x600mg i.v. for 2 weeks - Ciprofloxacin 2x500mg and Clindamycin 4x300mg p.o. for 4 more weeks If the pathogen can be identified - antibiotic treatment should be adapted to the susceptibilities of the microorganism.
Bed rest
References
Page 147 in: Hinchcliffe, Ronald; Fritz Hefti; Jundt, Gernot; Freuler, F. (2007). Pediatric Orthopedics in Practice. Berlin: Springer. ISBN3-540-69963-5.
^ Titlic, M.; Josipovic-Jelic, Z. (2008). "Spondylodiscitis". Bratislavske lekarske listy. 109 (8): 345–347. PMID18837241.