Espondilodiscitis en pediatría. Caso clínico
Rojas H., Juan Pablo
Gómez M., María del Pilar
Revista Chilena de Pediatría, 0370-4106, Vol. 85, Nro. 1, p. 68-73.
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Introduction: Spondylodiscitis (discitis plus osteomyelitis) is an infection of the spine that involves the intervertebral disc and the vertebral body. Patients present common symptoms although little specific, and suspicion for diagnosis is required. Most cases are resolved with pharmacological management; antibiotics remain as the main treatment. Objective: To describe a patient with a spondylodiscitis, the diagnostic and therapeutic approach. Case report: A 2-year-old preschooler, with three months of refusal to walk, pain associated with standing and sitting, and absence of fever throughout evolution is presented. Physical examination reported tenderness in the lumbar region, muscle contracture and decreased lumbar lordosis. No neurological involvement and negative Gowers’ sign were described. Lumbosacral spine X-ray and pelvic MRI showed abnormality of the L5-S1 disc, with bone erosions compatible with spondylodiscitis. Antibiotic treatment, physical rehabilitation and analgesia were administered, the patient completely evolved from condition. Conclusion: Spondylodiscitis must be considered in children with acute ambulation changes. The importance of prompt diagnosis and treatment involving the entire multidisciplinary team in order to improve the prognosis of patients is emphasized.
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