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Pediatric disk space infection
Other Resources UpToDate PubMed

Pediatric disk space infection

Contributors: Anusha Patil BA, Eric Ingerowski MD, FAAP
Other Resources UpToDate PubMed

Synopsis

Emergent Care / Stabilization:
Urgent referral to orthopedics is recommended for immediate evaluation and intervention.

Causes / typical injury mechanism:
  • Pediatric disk space infection is often caused by hematogenous spread of bacteria, commonly associated with systemic infections or conditions.
  • Injury mechanisms include trauma, surgeries, or infections that may introduce pathogens into the vertebral disk space.
Classic history and presentation:
  • Patients may present with back pain, refusal to move the spine secondary to pain, and localized tenderness.
  • Fever, irritability, and neurologic symptoms can accompany the presentation, indicating potential disk space involvement.
Prevalence: Pediatric disk space infections are relatively rare – 0.3 cases per 100 000.
  • Age – Occurs in individuals ages 20 years or younger due to residual vascular supply in the disk. There is a bimodal distribution of ages affected: 60% occurs between ages 6 months to 4 years and 40% occurs between ages 10-14 years.
  • Sex / gender – Both sexes are affected, with only a slight predilection for males reported.
Risk factors: Immunocompromised states (HIV / AIDS, transplants, immunosuppressive treatment, chronic kidney disease, diabetes), preexisting spinal disease, recent infection, or invasive procedures increase the risk of developing pediatric disk space infections.

Pathophysiology:
  • The causative pathogen is either directly inoculated into disk space (via trauma or invasive procedure) or through hematogenous spread from another site of infection.
  • Most commonly occurs in the lumbar spine because of the rich vascular supply from the Batson venous plexus.
  • The most common cause of pediatric disk space infection is Staphylococcus aureus.

Codes

ICD10CM:
1153396007 – Infection of intervertebral disc caused by bacterium
302935008 – Infective discitis

SNOMEDCT:
372109003 – Disorder of joint of spine

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Last Reviewed:07/13/2024
Last Updated:07/14/2024
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Pediatric disk space infection
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