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Septic spondylodiscitis in ankylosing spondylitis.
The Journal of Rheumatology
|June 1, 1987
Summary
Ankylosing spondylitis patients experiencing back pain require careful evaluation to distinguish between aseptic and septic spondylodiscitis. Early diagnosis is crucial, as delays can lead to severe complications like Staphylococcus aureus infections.
Area of Science:
- Rheumatology
- Infectious Diseases
- Spinal Medicine
Background:
- Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the spine.
- Patients with AS may present with back pain, complicating differential diagnosis.
- Septic spondylodiscitis is a serious spinal infection that requires prompt treatment.
Observation:
- A patient with a 10-year history of ankylosing spondylitis developed acute midback pain after minimal exertion.
- Medical evaluation was sought, but diagnosis of septic spondylodiscitis was delayed by three weeks.
- The patient later developed fever and admitted to intravenous drug use.
Findings:
- Staphylococcus aureus empyema and spondylodiscitis were diagnosed in the patient.
- The case highlights a delay in recognizing septic spondylodiscitis in an AS patient.
- Intravenous drug use was a contributing factor to the infection.
Implications:
- Clinical differentiation between aseptic and septic spondylodiscitis is critical in patients with ankylosing spondylitis.
- Prompt diagnosis and treatment of septic spondylodiscitis are essential to prevent severe outcomes.
- Healthcare providers must maintain a high index of suspicion for infection in AS patients presenting with new or worsening back pain, especially with risk factors.