“…3) was defined as an epidural mass with iso-or hypointensity on T1-weighted images, hyperintensity on T2-weighted images and linear enhancement surrounding non-enhancing purulent or necrotic matter on MRI [8]. Fig.…”
BackgroundTo the best of our knowledge, no study has compared gram-negative bacillary hematogenous pyogenic spondylodiscitis (GNB-HPS) with gram-positive coccal hematogenous pyogenic spondylodiscitis (GPC-HPS) regarding their clinical characteristics and outcomes.MethodsFrom January 2003 to January 2013, 54 patients who underwent combined antibiotic and surgical therapy in the treatment of hematogenous pyogenic spondylodiscitis were included.ResultsCompared with 37 GPC-HPS patients, the 17 GNB-HPS patients were more often found to be older individuals, a history of cancer, and a previous history of symptomatic urinary tract infection. They also had a less incidence of epidural abscess formation compared with GPC-HPS patients from findings on magnetic resonance imaging (MRI). Constitutional symptoms were the primary reasons for initial physician visits in GNB-HPS patients whereas pain in the affected spinal region was the most common manifestation in GPC-HPS patients at initial visit. The clinical outcomes of GNB-HPS patients under combined surgical and antibiotic treatment were not different from those of GPC-HPS patients. In multivariate analysis, independent predicting risk factors for GNB-HPS included a malignant history and constitutional symptoms and that for GPC-HPS was epidural abscess.ConclusionsThe clinical manifestations and MRI presentations of GNB-HPS were distinguishable from those of GPC-HPS.
“…3) was defined as an epidural mass with iso-or hypointensity on T1-weighted images, hyperintensity on T2-weighted images and linear enhancement surrounding non-enhancing purulent or necrotic matter on MRI [8]. Fig.…”
BackgroundTo the best of our knowledge, no study has compared gram-negative bacillary hematogenous pyogenic spondylodiscitis (GNB-HPS) with gram-positive coccal hematogenous pyogenic spondylodiscitis (GPC-HPS) regarding their clinical characteristics and outcomes.MethodsFrom January 2003 to January 2013, 54 patients who underwent combined antibiotic and surgical therapy in the treatment of hematogenous pyogenic spondylodiscitis were included.ResultsCompared with 37 GPC-HPS patients, the 17 GNB-HPS patients were more often found to be older individuals, a history of cancer, and a previous history of symptomatic urinary tract infection. They also had a less incidence of epidural abscess formation compared with GPC-HPS patients from findings on magnetic resonance imaging (MRI). Constitutional symptoms were the primary reasons for initial physician visits in GNB-HPS patients whereas pain in the affected spinal region was the most common manifestation in GPC-HPS patients at initial visit. The clinical outcomes of GNB-HPS patients under combined surgical and antibiotic treatment were not different from those of GPC-HPS patients. In multivariate analysis, independent predicting risk factors for GNB-HPS included a malignant history and constitutional symptoms and that for GPC-HPS was epidural abscess.ConclusionsThe clinical manifestations and MRI presentations of GNB-HPS were distinguishable from those of GPC-HPS.
“…In immunocompromised or immunosuppressed patients, or patients treated in intensive care units the infections of the spine and/or intervertebral discs can be caused by viruses, fungi or parasites [1–3,6,7]. …”
Section: Discussionmentioning
confidence: 99%
“…Untreated empyema may in turn cause inflammation of the spinal cord and/or meningitis. A rare complication, usually associated with tubercular infection, is the formation of fistulas to the skin surface or to the abdominal cavity [7,10,11]. The inflammatory process is accompanied by a progression of pathological lesions.…”
Section: Discussionmentioning
confidence: 99%
“…In case of intervertebral disc inflammation the discs are seen as strongly hyperintense in T2-weighted images, so called hot discs. However, it should be remembered that in spine inflammation of fungal etiology there is often no signal increase in T2-weighted images and the signal enhancement after contrast administration may be low or even undetectable [3,6,7,15,16]. …”
Section: Discussionmentioning
confidence: 99%
“…Differentiation between infection and cancer in early spondylodiscitis may be difficult, as the intervertebral disc is not affected yet or, in rare cases, the rear part of the vertebra is affected. In these cases, a thorough clinical comparison of a patient’s history, laboratory tests and imaging results is necessary [7]. …”
SummaryBackground:Spinal infection (discitis; spondylodiscitis) presents a wide spectrum of pathologies. The method of choice for spondylodiscitis imaging is magnetic resonance (MR). It provides detailed anatomical information, especially concerning epidural space and spinal cord. The main aim of this article is the description and evaluation of spondylodiscitis morphological variation visible in magnetic resonance imaging.Material/Methods:In this article we retrospectively analysed the patients diagnosed at the Department of Radiology of the Provincial Hospital No 2 in Rzeszów between October 2009 and October 2011. The subjects involved a group of five women aged 41–74 (mean 56.3 years) and eight men aged 46–69 (mean 61,3 years). All patients had spondylodiscitis symptoms. All patients underwent MRI examination before and after the contrast enhancement. In three patients additional CT examination was performed.Results:Following the MRI procedure all patients were diagnosed with typical symptoms of spondylodiscitis. It also revealed a number of pathologies resulting from morphological spondylodiscitis variation. Other pathologies found on the MR images of the study group patients involved epidural intra-canal spinal pathological masses causing spinal cord compression, lung abscess, pyothorax, paravertebral abscesses and epidural empyemas, abscess between adjacent vertebral bodies, abscesses beneath anterior longitudinal ligament, and iliopsoas muscle abscesses. In all cases a destruction of vertebral bodies with end plates loss restriction and cortical layer discontinuity was observed. Moreover, one person was diagnosed with pathological vertebral body fractures and liquefactive necrosis of the vertebral body.Conclusions:Spondylodiscitis manifests itself in a great number of morphological variations visible on the radiological images. Apart from ordinary features of vertebral bodies and discs, progressive spinal destruction is observed together with reactive bone changes and soft tissue infiltration. The latter leads to a number of complications e.g. abscesses or even fistulas and also to the formation of obstacles in radiological images. The knowledge of radiological images together with overall evaluation of clinical and laboratory features enables a proper diagnosis.
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