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[Intervertebral disk infection in children (author's transl)]
Insights
Discitis in young children presents diagnostic challenges. Early bone gammagraphy may aid in diagnosing this intervertebral disk infection, even with negative initial labs.
Area of Science:
- Pediatric infectious diseases
- Spinal infections
- Diagnostic imaging in children
Background:
- Discitis, an infection of the intervertebral disk, is difficult to diagnose in preschool-aged children.
- Early suspicion is often required for timely diagnosis.
Observation:
- Two pediatric cases (ages 2 and 4) presented with abdominal pain, mobility issues, and unusual sitting postures.
- Both cases involved the L4-L5 intervertebral disk.
- Initial laboratory tests, including bacteriology, were negative except for leucocytosis and elevated sedimentation rates.
Findings:
- Lumbar spine X-rays confirmed diagnoses in the third week of symptoms.
- Bone gammagraphy's value for early diagnosis is discussed.
- Favorable clinical outcomes were observed despite abnormal radiological findings.
Implications:
- Highlights the diagnostic challenges of pediatric discitis.
- Suggests bone gammagraphy as a potentially valuable tool for earlier detection.
- Emphasizes that clinical improvement can occur even with delayed radiological diagnosis.
Abstract:
Discitis, or infection of an intervertebral disk, is a diagnostic challenge in the preschool age, unless there is good reason for suspicion. Two children, two and four years old, are discussed here. They had abdominal pain for several days, difficulty in movement and anomalous sitting postures. In both, L4-L5 was affected, and laboratory, including bacteriology, studies were negative, except for leucocytosis and slight-to-moderately elevated sedimentation rates. The diagnoses were confirmed by lumbar spine X-rays, though not until the third week after onset of symptoms. Discussed are the values of bone gammagraphy in early diagnosis, favourable clinical evolution in spite of an abnormal radiological picture, and treatment.