title: Clinical features of cervical pyogenic spondylitis and intraspinal abscess.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  The purpose of the present study was to elucidate the clinical features of cervical pyogenic spondylitis and intraspinal abscess and to use this knowledge for early diagnosis and treatment.
  
  
  BACKGROUND
  Cervical pyogenic spondylitis and intraspinal abscess are relatively rare diseases in which accurate diagnosis is difficult at early stage. However, because both diseases can cause severe paralysis and vital crisis at advanced stages, early diagnosis and treatment are very important.
  
  
  METHODS
  Fourteen patients (men: 9, women: 5; average age at treatment: 65.4 y; age range: 49-89 y) with cervical pyogenic spondylitis and/or intraspinal abscess were treated in our hospital. We analyzed their initial symptoms, initial diagnosis, duration between the appearance of initial symptoms and final diagnosis, symptoms at final diagnosis, level of the affected cervical spine, predisposing factors, organisms, and treatments.
  
  
  RESULTS
  Initial symptoms included neck pain with fever (n=7), neck pain without fever (n=3), pharyngeal pain with fever (n=1), muscle weakness in both the upper and lower extremities (n=1), gait disturbance (n=1), and numbness of the lower extremities (n=1). Patients were initially diagnosed with meningitis (n=4), fever of unknown origin (n=2), cervical spondylosis (n=2), polymyalgia rheumatica (n=1), upper respiratory tract inflammation (n=1), metastatic spinal tumor (n=1), cervical spondylotic myelopathy (n=1), and cervical disc herniation (n=1). Of the 14 patients, 1 was correctly diagnosed with cervical pyogenic spondylitis.
  
  
  CONCLUSIONS
  The initial symptoms of cervical pyogenic spondylitis and intraspinal abscess varied and neck pain with fever was not essential. Therefore, doctors should consider the possibility of cervical pyogenic spondylitis and repeat the assessments of the clinical examination for early diagnosis of this disease.
authors: Department of Orthopedic Surgery, Faculty of Medicine, Oita University, Oita, Japan. masashim@med.oita-u.ac.jp
authors: Masashi
authors: M
authors: Miyazaki
authors: Toyomi
authors: T
authors: Yoshiiwa
authors: Ryuzo
authors: R
authors: Kodera
authors: Hiroshi
authors: H
authors: Tsumura
mesh_terms: D000038:Abscess / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000382:microbiology* / Q000473:pathology; D005260:Female; D005335:Fever of Unknown Origin / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology; D019547:Neck Pain / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology; D013166:Spondylitis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000473:pathology