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Latest revision as of 19:07, 18 September 2017

Vertebral osteomyelitis Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Vertebral osteomyelitis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

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MRI

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Cost-Effectiveness of Therapy

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

History and Symptoms

The disease is known for its subtle onset in patients, and few symptoms characterize vertebral osteomyelitis. Correct diagnosis of the disease is often delayed for an average of six to twelve weeks due to such vague, ambiguous symptoms.

General Cases

General symptoms found in a cross-section of patients with vertebral osteomyelitis include fever, swelling at the infection site, weakness of the vertebral column and surrounding muscles, episodes of night sweats, and difficulty transitioning from a standing to a sitting position. Additionally, persistent back pain and muscle spasms may become so debilitating that they confine the patient to a sedentary state, where even slight movement or jolting of the body results in excruciating pain. In children, the presence of vertebral osteomyelitis can be signaled by these symptoms, along with high-grade fevers and an increase in the body's leukocyte count.

Advanced Cases

  • Patients with an advanced case may present some or none of the symptoms associated with general cases of vertebral osteomyelitis.
  • When the osteomyelitis is isolated in the back, as it is in vertebral osteomyelitis, the patient will report muscle spasms coming from the back, but may not report experiencing any fevers.
  • Symptomatic signs vary in each patient and depend on the severity of the case.
  • Neurologic deficiency characterizes advanced, threatening cases of the disease.
  • On average, 40% of patients with an advanced case of vertebral osteomyelitis experience some type of neurological deficiency; this is a sign that the infection has been progressing for some time.
  • In advanced cases, the untreated infection will attack the nervous system through the spinal cord which runs parallel to the vertebral column, placing the patient at risk for paralysis of the extremities.
  • Additionally, loss of the ability to move is a trademark symptom of neurologic problems in advanced cases of vertebral osteomyelitis. Any further signs of neurological deficit signal an advanced case of vertebral osteomyelitis that requires immediate intervention to prevent further threat to the spinal cord.

References

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