Discitis
Background
- Infection of nucleus pulposus due to infection of vertebral body endplate cartilage
- Risk Factors: peds, post-op, immunocompromised
Clinical Features
- >90% p/w unremitting back or neck pain which awakens them at night
- Fever (60-70%)
- Neuro deficits (10-50%)
- ESR elevation (>90%)
- Leukocytosis (<50%)
Diagnosis
- Labs
- ESR elevated
- Imaging
- Plain films are rarely positive
- MRI is gold standard
Treatment
- IV abx
Disposition
- Admit to spine service
Source
- Rosen's
- Tintinalli