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- Title
Infective discitis in a District General Hospital.
- Authors
McCausland, E. M. A.; Liggett, N. W.; Forbes, R. B.
- Abstract
Infective discitis is a serious but treatable cause of back pain in adults. We report a series of cases presenting to a district general hospital over a three year period (2004-6). We reviewed case notes of eleven patients with a discharge coding diagnosis of 'discitis', and extracted clinical information: symptoms, predisposing factors, radiological imaging, time to diagnosis, microbial organisms, antibiotic therapy and functional outcome. All eleven patients (mean age 62 yrs, range 45-90) reported back pain at presentation. Pyrexia >37.5 was present in 10 patients with a mean CRP of 252 mg/l (range 101-560). Diabetes was the most common predisposing factor (27%), and one patient had had a recent invasive spinal procedure. Diagnosis was confirmed by MRI in the majority (63%). Median time from admission to confirmation of diagnosis was 6 days (1-15). Staphylococcus aureus was isolated from 5 patients. Choice of antibiotic and duration of treatment varied. At the time of this study 6 were walking independently, 4 with assistance, 1 was immobile and 1 was dead. Discitis accounted for 0.023% of DGH medical and surgical admissions during this period. The diagnosis is often not considered prior to imaging. It is more commonly appreciated as a complication of spinal surgery or invasive spinal procedures however spontaneous discitis is associated with advanced age, diabetes and systemic infection. Therefore in the setting of back pain, fever and elevated inflammatory markers infective discitis should be considered, especially in high risk groups.
- Subjects
INFECTION; BACKACHE; ANTIBIOTICS; FEVER; SPINAL surgery; INFLAMMATION
- Publication
Ulster Medical Journal, 2008, Vol 77, Issue 2, p138
- ISSN
0041-6193
- Publication type
Article