Discitis and Vertebral Osteomyelitis in Children: An 18-Year Review

Fernández, Marisol; Carrol, Clark L.; Baker, Carol J.

doi:10.1542/peds.105.6.1299

Cited by 253 publications

(186 citation statements)

References 16 publications

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“…However, infectious disease affecting the disks or the bone would cause loss of bone in limited lesions (Fernandez et al, 2000;Mulleman et al, 2006); this was not detected in our material. The observed patterns of the affected individuals in accordance with age, mechanical force, and development of lesions involving degenerative changes of the intervertebral disks all point towards degeneration, and hence, spondylosis deformans as the primary cause of the observed conditions.…”

Section: Discussionmentioning

confidence: 52%

“…X-ray examination (Fig. 5) supported this interpretation, and there were no signs of infectious spondylitis, which causes lesions with bone loss in humans (Fernandez et al, 2000;Mulleman et al, 2006). Without microscopy of the fresh specimens, however, it was not possible to reliably distinguish degeneration and inflammation as causes for the observed conditions.…”

Section: Diagnosismentioning

confidence: 78%

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Occurrence of Vertebral Osteophytosis in a Museum Sample of White-Beaked Dolphins (Lagenorhynchus Albirostris) From Danish Waters

Galatius

Sonne

Kinze³

et al. 2009

Journal of Wildlife Diseases

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ABSTRACT:The occurrence of pathologic new bone formation in the vertebral column was studied in 46 skeletons of the white-beaked dolphin (Lagenorhynchus albirostris) stranded in Denmark between 1903 and 2002 and held in the collections of the Zoological Museum, University of Copenhagen. New bone formation was evident in 18 (72%) of 25 physically mature specimens and in one of 21 physically immature specimens. This pattern of occurrence is consistent with spondylosis deformans, which is caused by degeneration of the intervertebral disk. In general, females seemed to be more susceptible, exhibiting a higher number of affected vertebrae and more severe cases. Lesions were predominantly detected in the lumbar and cranial caudal vertebra. Data on blubber thickness were available for part of the sample; one of the most heavily afflicted specimens had the thickest recorded blubber, indicating that secondary bone formation leading to blocks of fused vertebrae had not necessarily impaired the body condition of afflicted specimens. However, age determinations conducted on the sample revealed that none of the most severe cases occurred among the oldest animals, implying that these severe cases may cause premature fatality.

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Section: Discussionmentioning

confidence: 52%

Section: Diagnosismentioning

confidence: 78%

Occurrence of Vertebral Osteophytosis in a Museum Sample of White-Beaked Dolphins (Lagenorhynchus Albirostris) From Danish Waters

Galatius

Sonne

Kinze³

et al. 2009

Journal of Wildlife Diseases

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“…9 Evidence against an infectious etiology includes the fact that many cultures are sterile and some patients recover without antimicrobial therapy. 6 In contrast, some authors observed that patients who were treated with intravenous antibiotics for at least 6 days had a more rapid resolution of symptoms and also had the lowest likelihood of developing recurrent symptoms. 21 In human spondylodiscitis, the diagnostic yield of detecting the etiologic agent in tissue sections by histopathology is relatively low.…”

Section: Discussionmentioning

confidence: 97%

Bacterial Diskospondylitis Associated with Posterior Paresis/Paralysis in North American Farmed Mink (Mustela vison)

2005

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Abstract. Posterior paresis/paralysis in farmed mink is responsible for significant morbidity and mortality, with individual farms reporting the loss of as many as 700 animals each year. Although this disease has been recognized by North American mink farmers for approximately 40 years, there are few published reports focusing on this entity. The objective of this study was to investigate the etiology and pathogenesis of the disease. Complete necropsy examinations were done on 40 clinically affected mink, ranging from 7 to 10 weeks of age, and on three normal animals in the same age range from two mink farms. Thirty-two of the 40 clinically affected animals had an isolated vertebral lesion characterized by bone lysis and proliferation that usually was centered on an intervertebral disk space in the midthoracic area. An inflammatory reaction, composed primarily of neutrophils, was present within the vertebral sections in 25 of the 40 affected animals (62.5%), and the presence of gram-positive cocci was confirmed in 8 of 10 animals (80%) in which bacterial organisms were observed histologically. Bacterial cultures from 15 affected animals yielded Streptococcus sp. from the intervertebral disk space in 13 of 15 (86.7%) animals and from heart blood in 6 of 8 (75%). A farm visit revealed no history or evidence of traumatic wounds as a source of infection in these animals, and the diet appeared to be adequate for skeletal development. We conclude that posterior paresis/paralysis in farmed mink is associated with bacterial diskospondylitis, likely occurring secondary to bacteremia/septicemia.

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“…Existen tres métodos de acceso de los microorganismos al tejido vertebral: bacteriemia desde un foco séptico distante; inoculación directa secundaria a cirugía o trauma; y contigüidad por extensión de infecciones de vecindad [9][10] . La forma clínica más común es la hematógena, secundaria a infecciones urinarias, de piel y tejidos blandos, respiratorias y de herida quirúrgica 5 . Varios estudios han demostrado que el disco y el cuerpo vertebral comparten las mismas estructuras vasculares en el recién nacido, y gradualmente el disco se vuelve avascular en la vida adulta.…”

Section: Discussionunclassified

“…Los anillos apofi sarios superior e inferior de las dos vértebras adyacentes tienen una anastomosis común a través de las fi nas ramifi caciones adyacentes a la región postero-lateral del disco, permitiendo así que les llegue el fl ujo sanguíneo. Por medio de estas ramifi caciones, los microorganismos pueden atravesar la superfi cie del disco vía anastomosis, e infectar los cuerpos vertebrales adyacentes y posteriormente el espacio discal entre las dos vértebras afectadas [3][4][5][6] .…”

Section: Discussionunclassified

Espondilodiscitis causada por Kingella kingae en pediatría: reporte de un caso

Budnik

Porte²,

Arce

et al. 2011

Rev. chil. infectol.

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During the last years, spondilodiskitis due to Kingella kingae has been a new target of interest, since it is the second agent that causes non tuberculous espondilodiskitis in children, after Staphylococcus aureus. Its clinical presentation is very inespecifi c, sometimes with fever, abdominal or lumbar disconfort, nocturnal pain, altered walking and sedestation. Images, culture methods and PCR (polymerase chain reaction) can be helpful for diagnosis, although in an important percent of the cases, etiology cannot be determined. Although there are no established guidelines for treatment, before the suspicion, empiric antibiotic treatment should be started for good prognosis. We describe a case of a 3 year old boy, who had this disease and then a review about spondilodiskitis in childhood and microbiological aspects of Kingella kingae.Key words: Diskitis, Kingella kingae, infectious spondylitis, bone and joint infection, vertebral osteomyelitis. Palabras clave: Discitis, Kingella kingae, espondilitis infecciosa, infecciones osteoarticulares, osteomielitis vertebral.Universidad de Los Andes, Santiago, Chile. Facultad de Medicina (IBO).Clínica Santa María, Santiago, Chile. Servicio de Radiología (JDAV).Servicio de Traumatología (SVS). Servicio de Pediatría (JZR).Establecimiento(s) donde se realizó el trabajo: Clínica Santa María.Este trabajo no tiene conflictos de interés. IntroducciónL a espondilodiscitis es una patología muy infrecuente en pediatría, que requiere de un alto índice de sospecha diagnóstica, ya que un adecuado manejo determinará en parte el buen pronóstico. Aunque su etiología es controvertida, en la mayoría de los casos corresponde a infección de la columna vertebral que compromete el disco y los cuerpos vertebrales adyacentes. Avances en biología molecular han permitido identifi car nuevos agentes, particularmente Kingella kingae, cambiando el conocimiento de la etiología y así el enfoque terapéutico. En la actualidad, los agentes causantes descritos con mayor frecuencia son Staphylococcus aureus, Kingella kingae y Mycobacterium tuberculosis. La aproximación clínica de estos pacientes requiere del uso de imágenes y la obtención de muestra de tejidos para cultivo, estudio histológico y molecular. El tratamiento es con antimicrobianos, inicialmente endovenosos y luego orales, aunque no hay estudios que establezcan con certeza la terapia específi ca, su vía de administración y duración.Se describe a continuación el caso de un prescolar, que presentó una espondilodiscitis por K. kingae y posteriormente se realiza una revisión sobre esta localización de infección ostearticular en niños, fi nalizando con una actualización en K. kingae, patógeno que ha adquirido importancia en los últimos años en el desarrollo de infecciones osteo-articulares en niños.

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Discitis and Vertebral Osteomyelitis in Children: An 18-Year Review

Cited by 253 publications

References 16 publications

Occurrence of Vertebral Osteophytosis in a Museum Sample of White-Beaked Dolphins (Lagenorhynchus Albirostris) From Danish Waters

Occurrence of Vertebral Osteophytosis in a Museum Sample of White-Beaked Dolphins (Lagenorhynchus Albirostris) From Danish Waters

Bacterial Diskospondylitis Associated with Posterior Paresis/Paralysis in North American Farmed Mink (Mustela vison)

Espondilodiscitis causada por Kingella kingae en pediatría: reporte de un caso

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