The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Spondylodiscitis Misdiagnosed as Spinal Stenosis and Compression Fracture -A report of two cases-

요척주관 협착증과 압박 골절로 오인된 척추 추간판염 2예 -증례보고-

  • Hong, Ji Hee (Department of Anesthesiology and Pain Medicine, School of Medicine, Keimyung University) ;
  • Kim, Sae-Young (Department of Anesthesiology and Pain Medicine, School of Medicine, Keimyung University) ;
  • Han, Sung Ho (Department of Anesthesiology and Pain Medicine, School of Medicine, Keimyung University)
  • 홍지희 (계명대학교 의과대학 동산의료원 마취통증의학교실) ;
  • 김세영 (계명대학교 의과대학 동산의료원 마취통증의학교실) ;
  • 한성호 (계명대학교 의과대학 동산의료원 마취통증의학교실)
  • Received : 2009.05.29
  • Accepted : 2009.07.13
  • Published : 2009.08.01
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Abstract

Cases of pyogenic spondylodiscitis are relatively rare diseases that concern 2-7% of total cases of osteomyelitis. Owing to the low frequency and initial nonspecific nature of signs and symptoms, diagnosis is often delayed up to 2-6 months. If the proper treatment is not established due to a diagnostic delay, there is a possibility of a serious neurologic deficit and spinal instability. We report two cases of infectious spondylodiscitis which were misdiagnosed as compression fracture and spinal stenosis respectively. They could be correctly diagnosed after MRI and laboratory test and under the recovery state after an antifungal and antibiotic medication. Special careful attention during the diagnostic procedure is a really important step considering the diagnostic delay and its resultant unsatisfactory outcome.

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References

  1. Lestin F, Mann S, Podbielski A: Spondylodiscitis and paraspinal abscess caused by beta- haemolytic group G streptococci spreading from infected leg ulcers. J Med Microbiol 2008; 57: 1157-60 https://doi.org/10.1099/jmm.0.2008/000240-0
  2. Pobiel RS, Schellhas KP, Pollei SR, Johnson BA, Golden MJ, Eklund JA: Diskography: Infectious complications from a series of 12,634 cases. AJNR Am J Neuroradiol 2006; 27: 1930-2
  3. Hooten WM, Mizerak A, Carns PE, Huntoon MA: Discitis after lumbar epidural corticosteroid injection: a case report and analysis of the case report literature. Pain Med 2006; 7: 46-51 https://doi.org/10.1111/j.1526-4637.2006.00088.x
  4. Bettini N, Girardo M, Dema E, Cervellati S: Evaluation of conservative treatment of non specific spondylodiscitis. Eur Spine J 2009; 18(Suppl 1): 143-50 https://doi.org/10.1007/s00586-008-0841-4
  5. Buranapanitkit B, Lim A, Geater A: Misdiagnosis in vertebral osteomyelitis: problems and factors, J Med Assoc Thai 2001; 84: 1743-50
  6. Ledermann HP, Schweitzer ME, Morrison WB, Carrino JA: MR imaging findings in spinal infections: rules or myths? Radiology 2003; 228: 506-14 https://doi.org/10.1148/radiol.2282020752
  7. Torres-Ramos FM, Botwin K, Shah CP: Candida spondylodiscitis: an unusual case of thoracolumbar pain with review of imaging findings and description of the clinical condition. Pain Physician 2004; 7: 257-60
  8. Davis JS: Management of bone and joint infections due to Staphylococcus aureus. Intern Med J 2005; 35(Suppl 2): 79-96 https://doi.org/10.1111/j.1444-0903.2005.00982.x
  9. Hadjipavlou AG, Mader JT, Necessary JT, Muffoletto AJ: Hematogenous pyogenic spinal infections and their surgical management. Spine 2000; 25: 1668-79 https://doi.org/10.1097/00007632-200007010-00010
  10. Bodey GP, Mardani M, Hanna HA, Boktour M, Abbas J, Girgawy E, et al: The epidemiology of candida glabrata and candida albicans fungemia in immunocompromised patients with cancer. Am J Med 2002; 112: 380-5 https://doi.org/10.1016/S0002-9343(01)01130-5
  11. Smith AS, Blaser SI: Infectious and inflammatory processes of the spine. Radiol Clin North Am 1991; 29: 809-27