Diskitis, inflammation of the intervertebral disc is usually associated with
Staphylococcus aureus and rarely epidermal staphylococcus, Kingella kingae,
Enterobacteriaciae and
pneumococcus. In many cases, no growth of bacteria obtained from infected intervertebral discs. Although anaerobic bacteria were found
spondilodistsit from adults, these organisms have not been presented to the children. Recovery of anaerobic bacteria
in 2 children with diskitis reported. Patient 1. 10-year-old man entered the 6 weeks of low back pain and 2 weeks a slight fever and abdominal pain. Physical examination
was fine, except tenderness on percussion of the spine between thoracic vertebra 11 and lumbar vertebrae 2. The patient had a temperature >> << 104 `F. Laboratory tests were within normal limits, except for erythrocyte sedimentation rate (ESR), which was
58 mm / h. Blood cultures showed no growth. Magnetic resonance imaging with contrast hadolynyya showed minimal signs of inflammation
changes in the 12th thoracic vertebra / first lumbar vertebra disk. There was no other abnormalities. Computed tomography (CT) guided aspiration
space gave bloody material that was sent for aerobic and anaerobic cultures. Gram showed
numerous leukocytes and Gram-positive cocci in chains. Cultures for anaerobic bacteria gave a rapid growth
Peptostreptococcus Magnus, who was sensitive to penicillin, clindamycin and vancomycin. The patient was treated with intravenous penicillin 600000
U every 6 hours for 3 weeks and amoxicillin 500 mg every 6 hours for 3 weeks. Back Pain resolved within
2 weeks, and the ESR normalized at the end of therapy. Follow-up for 3 years showed complete resolution of infection purchase strattera. Patient 2. 8-year-old boy presented with back pain and low-grade fever, irritability, and malaise for 10 days. He
were upper respiratory tract infection with angina 27 days earlier, for which he received treatment. Patient
temperature of 102 `F, and physical examination was normal except for tenderness to percussion over the spine between >> << second and fourth lumbar vertebrae. Laboratory tests were normal except for ESR (42 mm / hr). Radiograph of the spine showed narrowing >> << third to the fourth lumbar vertebra disk space and uneven edges of the vertebral end. Computed tomography revealed a lytic lesion of bone of the lumbar vertebrae 4 and bone scans showed increased absorption
Technetium in the third or fourth lumbar vertebra disk space. CT-guided aspiration of space gave cloudy nonfoul smell
material that was sent for aerobic and anaerobic cultures. Gram showed numerous white blood cells are spindle and gram-negative bacteria
. Anaerobic culture grew light growth
Fusobacterium nucleatum. The body of b-lactamases and was susceptible to ticarcillin-clavulanate, clindamycin, metronidazole, and imipenem. Therapy with clindamycin 450 mg every 8 o'clock was parenterally for 3 weeks and orally for 3 weeks. Back pain decided
for 2 weeks. 2-year observation showed complete resolution and no recurrence. This report describes the first time
isolation of anaerobic bacteria in children with diskitis. The lack of recovery in previous reports, and >> << no bacterial growth in more than two-thirds of these studies may be caused by improper use of methods of collection, transportation and
processing. The correct choice of antimicrobial therapy diskitis can be achieved only by identifying
on pathogens and antimicrobial sensitivity. This is of particular importance in infections caused by anaerobic bacteria
, which are often resistant to antibiotics used for empirical treatment of diskitis. This was the case in our
second patient who was infected
F nucleatum, which was resistant to b-lactam antibiotics. The origin of anaerobic bacteria that cause infections in our patient
probably endogenous in nature. The presence of abdominal pain in the first child may have been associated with subclinical
abdominal pathothology. Preview throat in the other patient were possibly associated with potential hematogenous spread
F nucleatum. Magnus P was associated with infections of bones and joints. This report highlights the importance of a space culture
for aerobic and anaerobic bacteria in all children with diskitis. Future prospective studies to find out guarantee
The role of anaerobic bacteria in diskitis in children. . << >>
