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Epidemiological and clinical features of pyogenic spondylodiscitis

M Fantoni1, E M Trecarichi, B Rossi

  • 1Institute of Infectious Diseases, School of Medicine, Catholic University of the Sacred Heart, Rome, Italy. m.fantoni@rm.unicatt.it

European Review for Medical and Pharmacological Sciences
|June 5, 2012
PubMed

Insights

Pyogenic spondylodiscitis (PS) is a spinal infection affecting 0.4-2.4 per 100,000 annually in Europe. Staphylococcus aureus is the most common cause, with increasing incidence due to aging populations and medical advancements.

Area of Science:

  • Infectious Diseases
  • Orthopedics
  • Spinal Surgery

Background:

  • Pyogenic spondylodiscitis (PS) is a rare but significant infection, comprising 3-5% of osteomyelitis cases.
  • Incidence is rising due to increased life expectancy, immunocompromised patients, IV drug use, and spinal procedures.
  • Hematogenous spread is the most common transmission route for PS.

Purpose of the Study:

  • To review the epidemiology, causative agents, clinical presentation, and outcomes of pyogenic spondylodiscitis.
  • To highlight the increasing incidence and risk factors associated with PS.
  • To inform clinicians about the diagnostic and management challenges of this infection.

Main Methods:

  • Literature review of pyogenic spondylodiscitis cases.
  • Analysis of epidemiological data and causative microorganisms.
  • Summary of clinical symptoms, diagnostic findings, and treatment outcomes.

Main Results:

  • Staphylococcus aureus is the most frequent pathogen (approx. 50%), followed by Gram-negative rods (7-33%) and Coagulase-negative staphylococci (5-16%).
  • Key symptoms include severe back pain, often worse at night, and fever (approx. 50% of cases).
  • Mortality rates range from 0-11%, with potential for long-term complications like neurological deficits and persistent pain.

Conclusions:

  • PS incidence is increasing, necessitating awareness among healthcare providers.
  • Prompt diagnosis and appropriate treatment are crucial to minimize morbidity and mortality.
  • Continued research is needed to optimize management strategies for pyogenic spondylodiscitis.

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