Intervertebral Discitis in Children and Adolescents

Scoles, Peter V.; Quinn, Timothy

doi:10.1097/00003086-198201000-00006

Cited by 42 publications

(24 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The infection begins in one of the contiguous vertebral bodies or end-plates, and the disc is infected secondarily, or the disc is infected primarily by bloodborn bacteria (Scoles and Quinn 1982). Thus, the persisting presence of vessels in the outer annulus fibrosus and in the cartilage end-plates in infants and children as a site of entry for septic microemboli could be an important factor in the pathophysiology of disc infection.…”

Section: Discussionmentioning

confidence: 99%

Lymph and blood supply of the human intervertebral disc: Cadaver study of correlations to discitis

Rudert

Tillmann

1993

Acta Orthopaedica Scandinavica

137

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Lymph and blood supply of the human intervertebral disc: Cadaver study of correlations to discitis

Rudert

Tillmann

1993

Acta Orthopaedica Scandinavica

137

View full text Add to dashboard Cite

“…The white blood cell count is often within normal limits or slightly elevated with mild leukocytosis [103]. The ESR will be increased as the result of the infectious process [104][105][106]. The CRP, which will also be elevated, can serve as an indicator to follow-up the response to antibiotic therapy.…”

Section: Diskitismentioning

confidence: 99%

Back Pain in Children and Adolescents: Etiology, Clinical Approach and Treatment

Kalligeros¹

2006

CPR

View full text Add to dashboard Cite

The purpose of this systematic review is to investigate back pain as a clinical presentation in childhood and adolescence providing the clinician with a comprehensive approach, which will enable for an early recognition of those spinal disorders in need of more aggressive medical intervention. The current literature suggests that young people have a fairly high incidence of non-specific back pain, which seems to be much more frequent than traditionally reported. In schoolchildren, low back pain is mainly associated with psychosocial factors and seems to be mostly benign and selflimiting, therefore, only occasionally requiring medical attention. However, young patients who seek medical assistance, have a higher incidence of organic conditions that can manifest with spinal pain as their predominant symptom. The evaluation of a child or adolescent presenting with back pain can be a challenging task and requires skilled clinical expertise and a high index of suspicion. The physician should have a carefully planned strategy for assessing the pediatric spine patient, which should be accurate, reliable, consistent, and easily reproducible in delineating spinal pathologies. This should include a detailed history, physical examination, radiographic imaging, and appropriate diagnostic laboratory studies. A specific diagnosis will be established in at least 50% of the patients. In certain cases, an exact diagnosis cannot be made, and it is always advisable to re-evaluate the child after a period of initial observation. By then more serious problems will advance and become more obvious while minor symptoms not linked to an underlying pathology will resolve spontaneously.

show abstract

“…This is of particular importance in infections caused by anaerobic bacteria that are often resistant to antimicrobials used to empirically treat diskitis. This was the case in our second patient, who was infected by iskitis, an inflammation of the intervertebral disk, is generally attributable to Staphylococcus aureus [1][2][3][4][5] and rarely Staphylococcus epidermidis, Kingella kingae, [7][8][9] Enterobacteriaciae, 5,6 and Streptococcus pneumoniae. 10 In many cases, no bacterial growth is obtained from infected intervertebral discs.…”

mentioning

confidence: 99%

“…ESR, erythrocyte sedimentation rate; CT, computed tomography. D iskitis, an inflammation of the intervertebral disk, is generally attributable to Staphylococcus aureus 1-5 and rarely Staphylococcus epidermidis, Kingella kingae, 7-9 Enterobacteriaciae, 5,6 and Streptococcus pneumoniae. 10 In many cases, no bacterial growth is obtained from infected intervertebral discs.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Two Cases of Diskitis Attributable to Anaerobic Bacteria in Children

Brook

2001

Pediatrics

View full text Add to dashboard Cite

ABSTRACT. Diskitis, an inflammation of the intervertebral disk, is generally attributable to Staphylococcus aureus and rarely Staphylococcus epidermidis, Kingella kingae, Enterobacteriaciae, and Streptococcus pneumoniae. In many cases, no bacterial growth is obtained from infected intervertebral discs. Although anaerobic bacteria were recovered from adults with spondylodiscitis, these organisms were not reported before from children. The recovery of anaerobic bacteria in 2 children with diskitis is reported.Patient 1. A 10-year-old male presented with 6 weeks of low back pain and 2 weeks of low-grade fever and abdominal pain. Physical examination was normal except for tenderness to percussion over the spine between thoracic vertebra 11 and lumbar vertebra 2. The patient had a temperature of 104°F. Laboratory tests were within normal limits, except for erythrocyte sedimentation rate (ESR), which was 58 mm/hour. Blood culture showed no growth. Magnetic resonance imaging with gadolinium contrast revealed minimal inflammatory changes in the 12th thoracic vertebra/first lumbar vertebra disk. There was no other abnormality. A computed tomography (CT)-guided aspiration of the disk space yielded bloody material, which was sent for aerobic and anaerobic cultures. Gram stain showed numerous white blood cells and Gram-positive cocci in chains. Cultures for anaerobic bacteria yielded heavy growth of Peptostreptococcus magnus, which was susceptible to penicillin, clindamycin, and vancomycin. The patient was treated with intravenous penicillin 600 000 units every 6 hours for 3 weeks, and then oral amoxicillin, 500 mg every 6 hours for 3 weeks. The back pain resolved within 2 weeks, and the ESR returned to normal at the end of therapy. Follow-up for 3 years showed complete resolution of the infection.Patient 2. An 8-year-old boy presented with low back pain and low-grade fever, irritability, and general malaise for 10 days. He had had an upper respiratory tract infection with sore throat 27 days earlier, for which he received no therapy. The patient had a temperature of 102°F, and physical examination was normal except for tenderness to percussion over the spine between the second and fourth lumbar vertebrae. Laboratory tests were normal, except for the ESR (42 mm/hour). Radiographs of the spine showed narrowing of the third to fourth lumbar vertebra disk space and irregularity of the margins of the vertebral endplates. A CT scan revealed a lytic bone lesion at lumbar vertebra 4, and bone scan showed an increase uptake of 99m technetium at the third to fourth lumbar vertebra disk space. CT-guided aspiration of the disk space yielded cloudy nonfoul-smelling material, which was sent for aerobic and anaerobic cultures. Gram stain showed numerous white blood cells and fusiform Gram-negative bacilli. Anaerobic culture grew light growth of Fusobacterium nucleatum. The organism produced ␤-lactamase and was susceptible to ticarcillin-clavulanate, clindamycin, metronidazole, and imipenem. Therapy with clindamycin 450 mg every 8 hours w...

show abstract

Intervertebral Discitis in Children and Adolescents

Cited by 42 publications

References 0 publications

Lymph and blood supply of the human intervertebral disc: Cadaver study of correlations to discitis

Lymph and blood supply of the human intervertebral disc: Cadaver study of correlations to discitis

Back Pain in Children and Adolescents: Etiology, Clinical Approach and Treatment

Two Cases of Diskitis Attributable to Anaerobic Bacteria in Children

Contact Info

Product

Resources

About