tailieunhanh - Nhiễm trùng cột sống

Nhiễm trùng cột sống có thể xảy ra trong một loạt các tình huống lâm sàng. Trình bày của họ dao động từ trẻ sơ sinh với diskitis người là không muốn thu thập dữ liệu hoặc đi bộ đến người lớn phát triển bị nhiễm trùng sau khi một thủ tục sống. Các loại phổ biến nhất của bệnh nhiễm trùng cột sống là đường máu | Spinal Infections Bobby K-B Tay MD Jeffrey Deckey MD and Serena S. Hu MD Abstract Spinal infections can occur in a variety of clinical situations. Their presentation ranges from the infant with diskitis who is unwilling to crawl or walk to the adult who develops an infection after a spinal procedure. The most common types of spinal infections are hematogenous bacterial or fungal infections pediatric diskitis epidural abscess and postoperative infections. Prompt and accurate diagnosis of spinal infections the cornerstone of treatment requires a high index of suspicion in at-risk patients and the appropriate evaluation to identify the organism and determine the extent of infection. Neurologic function and spinal stability also should be carefully evaluated. The goals of therapy should include eradicating the infection relieving pain preserving or restoring neurologic function improving nutrition and maintaining spinal stability. J Am Acad Orthop Surg 2002 10 188-197 Before the introduction of modern antibiotic therapy mortality in patients with vertebral osteomyelitis was as high as 25 .1 Antibiotic therapy combined with surgical débridement and stabilization has decreased mortality to less than 5 to 15 .2-4 Early diagnosis also has improved outcomes by facilitating rapid initiation of antibiotic treatment and preventing abscess formation structural instability and neurologic deterioration. Spinal infections are evaluated according to their location the pathogen or pathogens involved route of the infection age of the patient and immune status of the host. The location of the infection may involve the osseous vertebra the intervertebral disk the epidural space or the surrounding soft tissues. The pathogens are usually either bacterial or fungal however the widespread use of broad-spectrum antibiotics and the increasing number of immunocompromised patients have led to infections with unusual organisms. A systematic approach must be taken in the diagnosis and treatment