[Septic spondylodiscitis: diagnosis and treatment].
We studied retrospectively 24 patients with septic discitis of different etiologies (hematogenic, primary and infantile) and the different aspects involved in its diagnosis and treatment. Erythrocyte sedimentation rate proved to be a valuable parameter and should always be interpreted carefully along with the clinical and neuroimaging findings. Biopsies should be reserved for doubtful cases with atypical course. Clinical treatment should be initiated after the following situations have been ruled out: sepsis, neurological deficit, severe deformity, epidural abscess and foreign body (primary disease). The surgical approach may be chosen based on the stage of disease, being preferably posterior in suppurative forms and anterior in the non-suppurative stage. Based on our experience and on information gathered by literature review, we propose an algorithm to guide diagnosis and treatment in patients with septic discitis.
Leal
Francisco Sérgio C Barros
FS
Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil. fcsergio@tuol.com.br
de Tella
Oswaldo Inácio
OI
Bonatelli
Antônio de Pádua Furquim
Ade P
Herculano
Marco Antônio
MA
Aguiar
Paulo Henrique
PH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D001424:Bacterial Infections; D002648:Child; D002675:Child, Preschool; D015299:Discitis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome