Vertebral osteomyelitis in infants

Abstract

Four infants between 2 and 13 weeks of age developed vertebral osteomyelitis. Their symptoms were different from those of children with discitis in that our patients were systemically ill, there was almost complete dissolution of involved vertebral bodies with either normal or nearly normal adjacent vertebral endplates, and three of the four children had recurrence of infection. The importance of long-term antibiotic treatment is emphasised. Years later the radiographic appearance of these children can be identical to congenital kyphosis with either anterior failure of segmentation or posterior hemivertebrae. The treatment should be the same as for congenital kyphosis with early bracing in extension and early fusion for progressive kyphosis.

Discitis in young children

“…Many authors recognise at least three distinct age groups affected by discitis, namely the neonate, the toddler and the early teenager. [8][9][10] To our knowledge we have described the largest series dealing only with the toddler age group. The clinical differences may be explained by the anatomy of the disc in the young, in which there are arterioles in the cartilage canals of the developing vertebral endplate.…”

Vertebral osteomyelitis in an infant presenting with pseudotumor and narrowing of the spinal canal

“…In series of patients with vertebral osteomyelitis, a biphasic age distribution with a peak during adolescence and a more prominent one in patients older than 50 years was reported [9][10][11]. Case reports of patients with severe vertebral osteomyelitis in infants less than 6 months of age support this observation [1,2,5,6,8].…”

“…Hematogenous osteomyelitis in the first months of life is rare, and its occurrence in the vertebrae even more so [1][2][3]. In the following, we report on diagnostic and therapeutic problems regarding an infant with vertebral osteomyelitis.…”

Spinal infections in children: A review

“…Neurologic manifestations occur frequently, and S. aureus is the major isolate from over 80% of cases. [46][47][48] About 60% of childhood spondylodiscitis occurs in children aged 6 months to 4 years, and most yield sterile biopsies or grow Kingella kingae. 34,49 Among patients older than 4 years, there is a greater risk for vertebral osteomyelitis, and the S. aureus is the predominant isolate.…”