Журнал клинических случаев

Spondylodiscitis Challenging Diagnosis in Immune Competent Child: A Case Report.

Abstract

Rana H Almaghrabi, Yameen A, Al Matawah, Abdulrahman M. Bin Hussain and Abdulrahman Alnemri

Spondylodiscitis, a combination of spondylitis and discitis, is an infection of the spine that involves the intervertebral disc and the vertebral body. Patients presented with little specific symptoms and suspicion for diagnosis is required. This report aimed to describe a female child patient with spondylodiscitis and to describe the diagnostic and therapeutic tools of such patient. This report recorded 2 year-old female child presented by fever, pain associated with standing and sitting, and 10 days history of refusal to walk in Prince Sultan Medical City, Riyadh, Saudi Arabia. Laboratory investigations as well as hip and knee ultrasound showed no abnormalities. However, and hip and lower back Magnetic Resonance Image (MRI) showed evidence of abnormal hyper intensity with enhancement of the bone marrow involving the vertebral bodies and adjacent endplates of 5th lumber (L5) and 1st sacral (S1) vertebrae with involvement of intervertebral disc space and paravertebral soft tissue component. Spondylodiscitis was suggested in the child, and conservative management by medical team of pediatrics and orthopedics consultant has immediately started. The treatment included antibiotics, non-steroidal analgesia and physical rehabilitation. The patient was completely evolved from condition within days. MRI taken 6 weeks later showed significant interval improvement of signs of spondylodiscitis, and the girl has been seen in the clinic after 4 months from discharge in good condition. Spondylodiscitis has to be considered in young children with acute ambulation changes. Prompt diagnosis and treatment involving the entire multidisciplinary team is emphasized in order to improve the prognosis of such patients.