Related Experiment Video
Updated: Sep 11, 2025
06:23
Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
4.9K
Risk Factors for Delayed Diagnosis of Pyogenic Spondylitis: A Cross-Sectional Study with Prospective Case Series
Tomoya Sato1,2, Katsuhisa Yamada1,2, Keigo Yasui2,3
1Department of Orthopaedic Surgery, Hokkaido University Hospital, Hokkaido, Japan.
Spine Surgery and Related Research
|August 11, 2025
Summary
Delayed diagnosis of pyogenic spondylitis, especially in the thoracic spine, leads to severe bone destruction and abscesses. Early detection is critical for better patient outcomes and preventing fatal consequences.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Radiology
Background:
- Delayed diagnosis and treatment of pyogenic spondylitis can result in severe, potentially fatal outcomes.
- Early detection and intervention are critical for effective management of pyogenic spondylitis.
Purpose of the Study:
- To identify factors influencing the time from symptom onset to diagnosis in patients with pyogenic spondylitis.
- To analyze risk factors associated with delayed diagnosis of pyogenic spondylitis.
Main Methods:
- A multicenter cross-sectional study with a prospective case series design.
- Inclusion of 74 patients hospitalized with pyogenic spondylitis between 2019 and 2023.
- Classification of patients into early (≤29 days) and delayed (>30 days) diagnosis groups for risk factor analysis.
Main Results:
- Significant risk factors for delayed diagnosis included advanced age, low white blood cell count, low C-reactive protein levels, and infection at a semi-rigid spinal level.
- Multivariate analysis identified semi-rigid spinal level location as a significant risk factor for delayed diagnosis (p=0.02).
- Delayed diagnosis was associated with significantly higher vertebral bone destruction rates and abscess cavity indices.
Conclusions:
- Infection at the semi-rigid thoracic spinal level is a significant risk factor for delayed diagnosis of pyogenic spondylodiscitis.
- Early diagnosis is crucial to prevent progressive bone destruction and large abscess formation.
- Increased clinical awareness of thoracic spinal infections is needed to facilitate early diagnosis and treatment.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
40
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
40
01:27Acute Pyelonephritis I: Introduction
50
Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
50
01:26Factors Affecting the Risk of Infection
12.3K
The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
12.3K
01:22Appendicitis-I: Introduction
621
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
621
01:25Urinary Tract Infection II: Pathophysiology
44
The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
44
01:19Pericarditis II: Clinical Features and Diagnostic Tests
24
Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
24