Infectious spondylodiscitis presenting with abdominal pain in the ED

Yu Che Chang, Ming Nan Huang, Jih Chang Chen, Ching Hsing Lee*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review


The infectious spondylodiscitis is a diagnostic and therapeutic challenge because the clinical signs and symptoms caused by spinal infections are usually subtle. The most common site of infection was the lumbar spine, followed by the thoracic spine. The main unspecific symptoms are inflammatory spine pain, associated or not with fever. The major predisposing risk factor seems to be uncontrolled diabetes. Most patients were symptomatic for between 2 and 10 weeks before presenting to the hospital. Most of them had elevated laboratory markers of inflammation, but the specificity of these markers is relatively low. Conservative management of pyogenic spinal infection with antibiotic therapy and spinal bracing seems sufficient in most cases. Antimicrobial therapy should be on the basis of microbiological diagnosis. However, in a minority of cases, surgical intervention is still warranted. Infectious spondylodiscitis has the potential to be a pitfall in the emergency department. Early and accurate diagnosis of spinal infections will lead to prompt treatment and favorable outcome for the patient. Emergency physicians should maintain a high index of suspicion for this disease when treating patients with chronic abdominal pain in the emergency department.

Original languageEnglish
Pages (from-to)133.e1-133.e3
JournalAmerican Journal of Emergency Medicine
Issue number1
StatePublished - 01 2011


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