Diferencia entre revisiones de «Vertebral osteomyelitis»
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m (Rossdonaldson1 moved page Vertebral Osteomyelitis to Vertebral osteomyelitis) |
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Revisión del 23:49 5 jun 2015
Clinical Features
- Pts usually have had prolonged symptoms (pain >3mo)
- Pts at risk for recent bacteremia
- Fever is a feature - however, pts are often afebrile
- Vertebral body tenderness
- Paravertebral muscle spasm unreponsive to conservative therapy
- Paravertebral or epidural abscess may develop
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
- Merck Manuals