[Infectious spondylodiskitis]

Abstract

Vertebral osteomyelitis is a rare entity. Its diagnosis is often difficult because of nonspecific symptons and the high frequency of back pain in general population. Aetiologic diagnosis is essential in order to perform specific treatment. Thus, blood cultures, serology, and culture of samples obtained by bone biopsy are the basis of the diagnosis. Magnetic resonance imaging permits an accurate diagnosis showing neurological involvement when it is present. ESR and CRP are good outcome markers. Endocarditis must be suspected in patients with predisposing heart condition, heart failure, positive blood cultures and infectyions caused by gram-positive organisms. Indications of surgery are severe neurological involvement, spinal instability and drainage of big abscesses. In Spain, as well as bacteria, we should consider M. tuberculosis, B. melitensis, and fungi as a potential aetiologic agents causing the infection.