Spine infections Flashcards
what are the two most common agens for vertebral infections?
- S.Aureus
- E.Coli
What are the three most common ways to get a vertebral osteomylitis?
*. urinary tract infection
*. respiratory tract infection
*. soft tissue infection
- hematigous spread
- direct spread.
when is surgery performed in vertebral osteomyelitis?
- needle biopsy for culture and to rule out malignancy
- Only if signs of instability.
What is Potts disease?
It tuberculous vertebral osteomyelitis
What is typical for Potts disease clinically?
- symphtomatic for months
- usually more than 2 levels
- prediletion for vertebral bodies.
- Commonly associated to psoas abscess.
- neurologic deficiency in 10-47%
- RARELY extend to medulla.
How is potts disease diagnosed?
y needle percutanous biopsy and identification of acid fast bacteria.
Obs! WBC count is usually not elevated.
When is surgery a choice for potts disease?
Surgery is only performed if signs of cord compression, instability or abcess is found.
What is discitis and when does it occur?
- infection of nucleus pulposus
- postoperatively
-spontaneous
What is juvenile discitis and what age is common?
Lumbar discitis
Age 2-3 years.
Risk disolves at 20-30yo when primordial feeding arteries that nourish the nucleus pulposus disappear.
When and how is juvenile discitis treated?
Most often nothing 8 not even immobilisation).
antibiotics if +culture (blood or biopsy) or High WBC count with systemic symtoms or high fever.
* surgery only for rare cases that progress albeit ab.
What are the 2 most common agens in adult form discitis?
- Staf aureus
- if drug abucer - Pseudomonas.
How many % of pt w adult form discitis need surgery?
25%.
- for differential diagnosis -neoplasm?
- to decompress
- drainage of abcess
* rarely due to instable spine.
What is wterhouse-Friederischen syndrome?
Complication to meningococcal infection, in children. 10-20%.
Large petechial hemorrhages.
Adrenal failure
DIC
