Intervertebral Disk Infections in Children

Intervertebral disc infection (Discitis) in childhood

“…The disease occurs only in childhood, probably because the particular blood supply of the child's disc enables direct hematogenic infection [3,5]. The vessels gradually involute in older children and in adults the disc is avascular [2,3,5,16]. While the disease has been described in children from 1 to 15 years [9,18,19], most cases occur below the age of 2 years [10,20].…”

“…The most common site of the disease is the lumbar spine mainly at the L4-Ls level [9,10,16]. Next in frequency is the dorsal spine.…”

“…In the majority of the cases the body temperature is normal. The clinical picture varies with age and frequently imitates other diseases [7,9,16]. Irritability and loss of appetite are common symptoms in young children [4,7,9,16].…”

“…The clinical picture varies with age and frequently imitates other diseases [7,9,16]. Irritability and loss of appetite are common symptoms in young children [4,7,9,16]. Refusal to sit and/or walk dominates the clinical presentation and is the initial finding in small children [18].…”

“…Although more than two hundred cases have been described in the medical literature under various names [17,19], this disease is not included in standard pediatric textbooks [14,15]. The clinical diagnosis can be difficult to establish, as the presentation of the disease can mimic other conditions such as meningitis, osteomyelitis, appendicitis, septic arthritis and others [7,9,16]. The key for the diagnosis is the awareness of the physician to this possibility and the inclusion of this disease in the differential diagnosis of children presenting with back pain, refusal to sit and walk, loss of appetite, irritability, abdominal pain and neck stiffness in the presence of low grade fever and elevated erythrocyte sedimentation rate.…”