UMEM Educational Pearls

Title: Pediatric Discitis

Category: Pediatrics

Keywords: Pediatric Discitis, epidural absces (PubMed Search)

Posted: 10/10/2008 by Don Van Wie, DO (Updated: 12/12/2024)
Click here to contact Don Van Wie, DO

Pediatric Discitis is an intervertebral disc infection due to hematogenous spread to vascular channels in cartilage that disappear later in life.  In 1/3 of patients it is caused by S. aureus.

Presenting Features

  • age <2.5 years (75%) 
  • Refuse or difficult to walk  (56%)
  • Back/neck pain (25-45%) ( 100%>3years)
  • Hx of fever (28-47%)
  • lumbaosacral area (78-82%)
  • Mean ESR 39-42
  • WBC> 10,500 (50%)
  • Abnormal MRI 90-100 %

Management is to exclude more severe disease (osteomylelitis,abscess, tumor) and antibiotic use is debatable.  Remember children this age rarely complain of back pain. 

 

References

Pediatrics 2000; 105: 1299