Hematogenous cervical spondylodiscitis after severe burn injury.
A 47-year-old man sustained a 31% TBSA burn injury. In spite of early escharectomy and mesh-graft-transplantation the patient suffered a septicaemic phase in the first week, which was treated by a specific antibiotic. Five weeks after the burn injury a cervical spondylodiscitis was diagnosed. Immediate wound debridement, ventral and dorsal spondylodesis with a tricortical bone-graft from the left iliac crest and titanium plates and specific antibiotic therapy led to the stabilization and healing of the cervical spinal column. The spondylodiscitis was microbiologically proved to be hematogenous after spread of Staphylococcus aureus from the blood in the early septicaemic phase. Swab culture from the burn surface wound, infected vertebrae and blood during the septicaemic phase revealed coagulase positive S. aureus. The aetiology, predisposing factors and management of this rare, but recognized, complication of major burns are discussed. Case features of this patient are compared with the single site's reported case of hematogenous cervical spondylodiscitis after severe burn injury.
Riedel
G
G
Department of Plastic and Handsurgery, Burn Center, BG-Clinics 'Bergmannstrost', Merseburger Strasse 165, 06112, Halle/Saale, Germany. guenther.riedel@bergmannstrost.com
Becker
S
S
Steen
M
M
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002056:Burns / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D002574:Cervical Vertebrae; D003131:Combined Modality Therapy; D015299:Discitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D018805:Sepsis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016038:Skin Transplantation / Q000009:adverse effects / Q000379:methods; D013123:Spinal Fusion / Q000379:methods; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D000900:Anti-Bacterial Agents