Delayed Osteomyelitis Diagnosis and Treatment in a Teenager
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Vertebral Osteomyelitis
Vertebra
Vertebral Osteomyelitis
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Vertebral Osteomyelitis
Vertebra
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Vertebral Osteomyelitis
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Osteomyelitis is an inflammation of bone caused by a pyogenic organism. Osteomyelitis is one of the most important musculoskeletal infections, commonly occurring in long bones. Vertebral osteomyelitis is fairly rare and is often overlooked. It is usually acquired hematogenously, although there are other ways of infection. Only about half of patients develop fever > 38 °C and symptoms are unspecific. The most common organism is <i>Staphylococcus aureus</i>, with <i>Pseudomonas aeruginosa</i> being an unexpected pathogen accounting for about 6%. We present a case of a 56-year-old Hispanic male that visited emergency room presenting with back pain of 3 weeks of evolution being discharged home. Patient returned 2 days after with no improvement. Blood test returned under normal range. Physical exam showed a focal tenderness at thoracic level. Blood culture recovered <i>Pseudomonas aeruginosa</i> sensitive to levofloxacin. CT/MRI was performed and showed vertebral osteomyelitis. Antibiotic was started for 6 weeks. Therapy was guided with erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP). Patient was evaluated monthly for 6 months and improved. Vertebral osteomyelitis is a challenging diagnosis. The consequences of the disease are dire if not diagnosed on time. Historically, the diagnosis of vertebral osteomyelitis remains in a positive culture of bone biopsy. Nowadays, when handling a suspected hematogenous vertebral osteomyelitis, blood culture has gained importance. Whether a blood culture recovered a pathogen, therapy should be based on sensitivity and can be guided following ESR/CRP levels. This type of management can preclude invasive and expensive methods, such as bone biopsy. J Med Cases. 2017;8(8):246-248 doi: https://doi.org/10.14740/jmc2870w
Vertebral Osteomyelitis
Erythrocyte sedimentation rate
Blood Culture
Microbiological culture
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Vertebral Osteomyelitis
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Vertebral Osteomyelitis
Bone disease
Bone Infection
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Vertebral osteomyelitis (also termed spinal osteomyelitis, spondylodiskitis, or disk-space infection) is a bone infection and inflammation, considered as a type of osteomyelitis concentrated in the spinal region. Cases of this condition are so rare, because only 2-4% of all bone infections are attributed to the disease. It is considered uncommon, with an incidence of 1 case per 100,000-250,000 population per year. However, some reviews suggest that the incidence of spinal infections is now increasing. We present the case of a 49 year old male who presented with symptoms of Pott’s spine, but eventually diagnosed with Staphylococcus aureus vertebral osteomyelitis of D7 & D8 with secondary pathological fracture and epidural abscesses, decompression with stabilization done.
Vertebral Osteomyelitis
Spondylodiscitis
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Vertebral osteomyelitis is a rare but serious infectious disease that causes inflammation and destruction of the spinal vertebrae. Prompt diagnosis and treatment are essential to avoid adverse outcomes. This article reviews risk factors for vertebral osteomyelitis, disease mechanisms, signs and symptoms, and diagnostic criteria. Medical imaging techniques for vertebral osteomyelitis are a main focus, and treatment, prognosis, and possible complications also are discussed. Finally, the special case of pediatric patients with vertebral osteomyelitis is presented.
Vertebral Osteomyelitis
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This report describes a patient with AIDS who presented with vertebral osteomyelitis secondary to Mycobacterium avium complex (MAC). We briefly discuss the literature regarding MAC osteomyelitis in patients with and without AIDS. This patient's course demonstrates the need for a microbiological diagnosis in order to optimally manage osteomyelitis in patients with AIDS.
Mycobacterium avium complex
Vertebral Osteomyelitis
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