This article was sent to me recently by a UK patient and I thought I already posted it -- but I may have missed it. See below.
BTW, a funny note for the old-timers in this forum: Tracy was right about the French medical professionals...they really do have their sh** together!
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1: J Infect. 2008 Jun;56(6):401-12. Epub 2008 Apr 28.
Infectious spondylodiscitis.
Cottle L, Riordan T.
Department of Infection and Tropical Medicine, RoyalHallamshireHospital, Sheffield, S10 2JF, UK.
OBJECTIVES: To review the available literature on infectious spondylodiscitis and provide recommendations on management, particularly identification of the causative agent and antimicrobial therapy.
METHODS AND RESULTS: The medical literature was searched using PubMed, employing the key words discitis, disc space infection, infectious spondylodiscitis, pyogenic discitis, septic discitis and post-operative discitis. Infectious spondylodiscitis is rising in incidence and diagnosis has been facilitated by the availability of sensitive imaging techniques such as MRI. No randomized controlled studies of antimicrobial therapy were identified in this literature search and there appear to be no UK consensus guidelines on investigation and management. Comprehensive French guidelines have been published and were scrutinized for this review.
CONCLUSIONS: Unless the patient is severely unwell antimicrobial therapy should be delayed until a microbiological diagnosis is established. If initial blood cultures are negative then a CT-guided biopsy should be conducted. Tentative recommendations for antimicrobial therapy can be made based on theoretical considerations and limited data from uncontrolled studies.
PMID: 18442854 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/18442854