And Discitis

Spinal infections are not commonly seen in general practices. Unfortunately, however, they are not rare and quite often are diagnosed late. Predisposing factors include diabetes, intravenous drug abuse, septicemia, and compromised immunity as seen in HIV, malignancies, chronic steroid consumption, and malnutrition. Delayed diagnosis has detrimental effects as the infection tends to spread and results in irreversible damage to the vertebral bodies, discs, and ligaments. This frequently results in significant morbidity and, at times, mortality.

Pyogenic infections usually occur in patients over 50 years old. Many patients do not appear systemically ill in the initial stages of the disease and remain afebrile with a normal white blood cell count for quite some time. More than 50% of infections involve the lumbar spine, and the causative agent will turn out to be staphylococ-cus aureus. Immunocompromised patients, however, will often have gram-negative infections such as pseudomonas or klebsiella. In most patients following interventional procedures or surgery, the bacteria reach the vertebral bodies via the arterial system or through venous dissemination. A common source of infection in elderly males is the lower urinary tract.

Clinical Presentation

Patients usually present with severe, longstanding axial pain that does not go away with rest. Local tenderness, muscle spasm, and limited spinal range of motion are frequently observed. Only a small percentage of patients develop motor or sensory deficits. Thus, every patient with persistent, unremitting pain should undergo a work-up that includes complete blood count with differential, C-reactive protein or sedimentation rate, bone markers, and serum and urine protein electrophoresis. Initially, plain X-rays and bone scan should be obtained. When infection is suspected repeated blood cultures and

Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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