CASE REPORTS   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2015 October;174(10):483-6

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Three cases of pyogenic spondylodiscitis following urinary tract infection: a case series and review of the literature

Yaegashi H. ^{1, 2}, Koshida K. ¹, Ikeda K. ³, Namiki M. ²

¹ Department of Urology, Kanazawa Medical Center, Kanazawa, Japan; ² Department of Integrative Cancer and Urology, Kanazawa University Hospital, Kanazawa, Japan; ³ Department of Orthopedics, Kanazawa Medical Center, Kanazawa, Japan

Pyogenic spondylodiscitis is a rare disease that is most commonly seen in patients with diabetes mellitus, hemodialysis, and with malignant tumors (i.e., “compromised hosts”). The incidence of this disease is increasing. Here, we present three new cases of pyogenic spondylodiscitis following urinary tract infection encountered at our hospital. We also discuss risk factors and means of rapid diagnosis. The median age at diagnosis was 82 years (range 70-84 years), and all patients were female. The first and second cases had malnutrition and the third had diabetes mellitus. The patient in the second case had malformation of the urinary tract. The first patient was infected with E. coli, the second was infected with MRSA, and the third had no identifiable pathogen. All three cases were diagnosed by magnetic resonance imaging. It is difficult to distinguish this disease from pyelonephritis because of similarity in clinical symptoms, findings, and laboratory data. Some reports have indicated difficulty in diagnosis of pyogenic spondylodiscitis. However, the median time to diagnosis of pyogenic spondylodiscitis after the onset of symptoms in our case series was 11 days by using magnetic resonance imaging, and it is much shorter than other reports. This disease should be taken into consideration in cases of intractable urinary tract infection.