Spinal Infections
A 68-year-old diabetic man presents with 6 weeks of progressive lower back pain, fever, and night sweats. He had a dental procedure 8 weeks ago. Examination reveals severe tenderness at L3-L4 with restricted lumbar motion but no neurological deficit. Blood tests show WBC 14,000, CRP 120 mg/L, ESR 85 mm/hr. MRI shows T1 hypointensity and T2 hyperintensity at L3-L4 disc space with endplate destruction and a paravertebral abscess. The spine surgeon discusses the likely diagnosis, need for tissue biopsy, antibiotic selection, and indications for surgery. Regarding spinal infections:
Mark each as TRUE or FALSE
PYOGENIC spondylodiscitis is HEMATOGENOUS spread from distant source (bacteremia from UTI, dental, I...
MRI is the GOLD STANDARD imaging: T1 hypointense, T2 hyperintense disc and adjacent endplates; DISC ...
Spinal infections are always traumatic in origin; E. coli is the most common organism (90%); cervica...
TUBERCULOSIS (TB) spondylitis (Pott's disease) affects THORACIC spine (50%), has SUBACUTE presentati...
Treatment: MEDICAL first-line (IV then oral antibiotics 6-12 weeks, culture-directed); empiric = van...
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Click T (True) or F (False) for each option