Vertebral Osteomyelitis: Still a Diagnostic Pitfall

doi:10.1001/archinte.1976.03630010083017

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Vol. 136 No. 1, January 1976

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Vertebral Osteomyelitis

Still a Diagnostic Pitfall

Daniel M. Musher, MD; Sigurdur B. Thorsteinsson, MD; John N. Minuth, MD; Robert J. Luchi, MD

Arch Intern Med. 1976;136(1):105-110.

Abstract

Vertebral osteomyelitis is still a diagnostic problem. Nonspecificsymptoms (low-grade fever, malaise, and weight loss) may dominate.Specific infections may be suggested by the history, and thediagnosis may be reinforced by a transient response to antibiotics.The patient may have symptoms resulting from a secondary paravertebralabscess. Even with fever, back pain, and point tenderness overthe vertebral column, the correct diagnosis may not be considered.Predisposing conditions include drug addiction, instrumentationof the infected urinary tract, bacteremia from other causes,or previous back surgery. Diagnosis is made by roentgenographicstudies and isolation of the causative organism from blood culturesor from the infected area. Staphylococcus aureus is the mostcommon pathogen, although other microorganisms may be responsible.Intensive intravenous antibiotic treatment appears to be curative,without surgical debridement, external stabilization, or prolongedoral administration of antibiotics.

(Arch Intern Med 136:105-110, 1976)

Author Affiliations

From the Infectious Disease Section, Department of Medicine, Veterans Administration Hospital, and Baylor College of Medicine, Houston.

Footnotes

Received for publication May 15, 1975; accepted June 14.

Reprint requests to Infectious Disease Section, Department ofMedicine, Veterans Administration Hospital, 2002 Holcombe Blvd,Houston, TX 77211 (Dr Musher).

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