Atypical spinal infections in immunocompromised patients

Abstract

Spinal infections in immunocompromised patients are a potential threat due to atypical presentations and delay in diagnosis. These patients often present with back pain, fever, and neurological deficits. It is crucial to have knowledge of atypical etiology of vertebral osteomyelitis. Immunocompromised status of the patients presumably prevents them from mounting an inflammatory or vascular response necessary to counter the disease process. The diagnostic delay of such disastrous conditions remains unsatisfactorily long. Identification of the causative microorganisms and timely initiation of treatment are of prime importance in the management of such infections. Magnetic resonance imaging with/without gadolinium contrast is the choice of noninvasive investigation in spinal infections, and an appropriate tissue biopsy for isolation of causative organism is required for confirmation of the diagnosis. Patients are best managed by a multidisciplinary approach. Surgical intervention may be necessary for effective management and prevention of complications due to atypical spinal infections.

Keywords

• atypical spinal infection
• immunocompromised host
• spondylodiscitis