Total spine magnetic resonance imaging for detection of multifocal infection in pyogenic spondylodiscitis: a retrospective observational study

Henkelmann, Jeanette; Denecke, Timm; Pieroh, Philipp; Einhorn, Stephanie; Höh, Nicolas H. von der; Heyde, Christoph-Eckhard; Voelker, Anna

doi:10.1186/s12891-020-03928-5

Cited by 6 publications

(6 citation statements)

References 28 publications

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“…It is worth mentioning that 17% of patients had multifocal infections at the time of diagnosis. Henkelmann et al, 30 in a retrospective series of 69 patients, found a prevalence of multifocal spondylodiscitis of 13%. Similar prevalence was observed by Stangenberg in 211 patients.…”

Section: Discussionmentioning

confidence: 95%

Primary spinal infections in patients with solid organ transplant: a systematic literature review and illustrative case

Hatter¹,

Beyer²,

Camino-Willhuber³

et al. 2022

Journal of Neurosurgery: Case Lessons

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BACKGROUND Primary spinal infections (PSIs) are a group of uncommon but serious infectious diseases considered more prevalent and aggressive among patients with chronic immunocompromised states. Association of PSI and solid organ transplant has not been systematically analyzed. The authors performed a systematic review analyzing clinical presentation and mortality of patients with PSI in the setting of solid organ transplant. OBSERVATIONS PSIs in patients with immunosuppressive therapy, such as those with solid organ transplant, may behave differently in terms of epidemiology, clinical presentation, and outcomes compared with nonimmunosuppressed patients. Overall PSI in solid organ transplant patients is associated with a high rate of neurological compromise, postoperative complications, and mortality. LESSONS Accurate diagnosis and appropriate treatment of PSI require a multidisciplinary effort. Localized pain is the most frequently reported symptom associated with PSI. As opposed to PSI in patients without transplant, inflammatory and infectious markers such as white blood cells and C-reactive protein are often not elevated. Furthermore, the causative microorganism profile varies significantly when compared to pyogenic spinal infection in patients without transplant. Aspergillus species was responsible for spondylodiscitis in transplant patients in more than 50% of cases, and the incidence of Aspergillus infection is projected to rise in the coming years.

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Section: Discussionmentioning

confidence: 95%

Primary spinal infections in patients with solid organ transplant: a systematic literature review and illustrative case

Hatter¹,

Beyer²,

Camino-Willhuber³

et al. 2022

Journal of Neurosurgery: Case Lessons

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“…A retrospective study of multifocal spondylodiscitis identified two patients with rheumatoid arthritis who were under anti-TNF-alpha drugs (namely adalimumab and etanercept). 6,7 Pyogenic spondylodiscitis most frequently affects the lumbar spine followed by thoracic and cervical, with multifocal involvement occurring only in 4-8% of cases 2,4,8 . Cervical involvement is found to be associated with the presence of epidural abscess more frequently as well as neurological deficits when compared with the other segments of the spine.…”

Section: Discussionmentioning

confidence: 99%

Espondilodiscitis multifocal y meningoencefalitis por Staphylococcus aureus en un paciente inmunocomprometido

Marques Dias,

Cabrita Abreu,

Grilo

et al. 2024

Gal. Clin.

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Spondylodiscitis is a rare diagnosis, but its incidence has increased in recent years. It represents 3-5% of osteomyelitis, and the multifocal affliction is rare as it occurs in 4-8% of all spondylodiscitis. The occurrence of meningoencephalitis associated with spondylodiscitis is also a rare association.We present the case of a 54-year-old woman diagnosed with multifocal spondylodiscitis complicated with meningoencephalitis and intracanal and paravertebral abscess with identification in blood cultures of Staphylococcus aureus. Immunosuppression with infliximab was identified as a risk factor.The patient underwent targeted antibiotic therapy, opting for the conservative strategy due to the surgical risk. There was a positive evolution with imaging resolution of the intracanal abscess.This case is of particular importance due to its rarity of frequency and considering the etiological agent and the low frequency of this infection in patients under anti-TNF-alpha therapy.

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“…This is in line with the values previously reported in the literature for rates of multifocal involvement in spinal infection. 30 , 31 However, no direct relationship has been found between multifocal involvement and severity of spinal infection in the literature. 31 …”

Section: Discussionmentioning

confidence: 99%

“… 30 , 31 However, no direct relationship has been found between multifocal involvement and severity of spinal infection in the literature. 31 …”

Section: Discussionmentioning

confidence: 99%

Surgical treatment in primary spinal infections in a pediatric population: illustrative case

Beyer¹,

Franklin²,

Hatter³

et al. 2022

Journal of Neurosurgery: Case Lessons

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BACKGROUND Primary spinal infections (PSIs) are a group of uncommon but serious infectious diseases that are characterized by inflammation of the endplate-disc unit. Pediatric spinal infection is rare and challenging to diagnose due to vague presenting symptoms. Most cases are conservatively managed with surgery rarely indicated. The authors performed a systematic review to study the baseline characteristics, clinical presentation, and outcomes of pediatric patients with PSIs who underwent surgical treatment. OBSERVATIONS PSI in pediatric patients might behave differently in terms of epidemiology, clinical presentation, and outcomes when compared with nonpediatric patients. Overall, PSI ultimately managed surgically in pediatric patients is associated with a high rate of localized pain, neurological compromise, and treatment failure when compared with nonsurgically managed pediatric spinal infections. LESSONS PSIs managed surgically in the pediatric population were found to be caused by Mycobacterium tuberculosis in 74.4% of cases and were associated with higher rates of localized pain, neurological compromise, and treatment failure than nonsurgically managed pediatric spinal infections. Thoracic involvement (71.8%) in the spinal infection was reported most commonly in our review. When omitting the cases involving M. tuberculosis infection, it was revealed that 50% of the pediatric cases involved infection in the cervical region, suggesting increased severity and disease course of cervical spinal infections in the pediatric population. Surgical treatment is indicated only in cases of severe neurological compromise and treatment failure.

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Total spine magnetic resonance imaging for detection of multifocal infection in pyogenic spondylodiscitis: a retrospective observational study

Cited by 6 publications

References 28 publications

Primary spinal infections in patients with solid organ transplant: a systematic literature review and illustrative case

Primary spinal infections in patients with solid organ transplant: a systematic literature review and illustrative case

Espondilodiscitis multifocal y meningoencefalitis por Staphylococcus aureus en un paciente inmunocomprometido

Surgical treatment in primary spinal infections in a pediatric population: illustrative case

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