Last reviewed: November 2017
Last updated: September  2016

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • fever
  • spinal pain or tenderness
  • weakness of extremities
  • paralysis
  • sensory disturbance
  • abnormal reflexes

Other diagnostic factors

  • isolated sphincter dysfunction

Risk factors

  • intravenous drug use
  • recent spinal surgery or trauma
  • indwelling spinal catheter
  • concomitant local infection
  • immunosuppression
  • diabetes mellitus
  • male sex
  • concomitant endocarditis
  • alcohol abuse
  • UTI
  • renal failure
  • chronic renal disease
  • chronic liver disease

Diagnostic investigations

1st investigations to order

  • FBC
  • CRP
  • ESR
  • gadolinium-enhanced diffusion-weighted MRI spine
  • blood cultures
Full details

Investigations to consider

  • direct abscess aspiration for culture
  • PCR of aspirate
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Kenneth F. Casey

Associate Adjunct Professor

Clinical Associate Professor of Physical Medicine and Rehabilitation

Wayne State University School of Medicine

Clinical Associate Professor Surgery (Neurosurgery)

Michigan State University

Detroit

MI

Disclosures

KFC declares that he has no competing interests.

Peer reviewers VIEW ALL

Consultant

Infectious Diseases

Associate Professor

Section of Infectious Diseases

Department of Medicine

University of Manitoba

Director

Infection Prevention and Control Unit Health Sciences Centre

Winnipeg

Manitoba

Canada

Disclosures

JME declares that he has no competing interests.

Consultant Anaesthetist

Derriford Hospital

Plymouth

UK

Disclosures

IC declares that he has no competing interests.

Assistant Professor

Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine

The Johns Hopkins University

Baltimore

MD

Disclosures

WZ declares that she has no competing interests.

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