Vertebral osteomyelitis

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Clinical Features

  • Pts usually have had prolonged symptoms (pain >3mo)
  • Fever
  • Vertebral body tenderness

Diagnosis

  • ESR (almost always elevated)
  • Blood cx
  • Imaging
    • May take 2-8 weeks to see changes
    • Bony destruction, irregularity of vertebral end places, disk space narrowing

Treatment

  • Antibiotics
    • Usually requires IV abx x6wk, then PO abx x 4-8wk
    • Consult w/ spine surgeon before starting antibiotics (may interfere w/ biopsy culture)
    • Piperacillin-tazobactam 3.375gm IV + vanco 1gm IV

Source

  • Tintinalli
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