Pyogenic Cervical Spondylodiskitis: Case Report and Current Literature Review

Abstract

Background: Cervical pyogenic spondylodiskitis accounts for less than 11% of all infectious spondylodiskitis. Its main origin is hematogenous, its most common etiological agent is Staphylococcus aureus, and however, different microorganisms can be found to cause this infection. Its insidious course, aggressiveness, mortality and high risk of sequela make timely diagnosis and early treatment a fundamental part of the patient's prognosis.Case presentation: 47 year old woman, with type II diabetes mellitus and arterial hypertension with quadriparesis of three months evolution. A diagnosis of pyogenic spondylodiskitis C4-C5 ASIA C due to Staphylococcus aureus was made, cervical debridement, decompression and fusion were performed and intravenous vancomycin and meropenem were administered for nine days.Results: She had a satisfactory outcome in the postoperative period, leaving the hospital with oral levofloxacin for three months, presenting recovery of general neurological status and gait recovery (ASIA E). Conclusion:There are several reports on elevated probability of neurological disease and its sequela, as well as on its high mortality rate (21%); however, there are few studies with an adequate level of evidence regarding the diagnosis and treatment of cervical ED.The current guidelines suggest the early empiric broad spectrum antibiotic administration within the first contact in aggressive cases, and posterior surgical treatment in addition to specific antibiotic therapy.