Description
Septic discitis is a pyogenic spinal infection, which involves the disc space and adjacent vertebral bodies most commonly in the lumbar spine. It can be complicated by epidural abscess, nerve root and spinal compression. It is an uncommon condition and pre-disposing factors include old age, steroids, immunosuppressive drugs, diabetes, urinary tract surgery and septicaemia. Back pain, fever and high ESR are the most common presenting features, although atypical presentations may cause confusion and diagnostic delays averaging around three months are characteristic. Radiological changes take several weeks to occur but changes are present early on MRI. Staphylococcus aureus and gramnegative organisms account for most of the cases. Antibiotic therapy, initially intravenous then oral for a total of three months is appropriate.
