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((More citations needed|date=April 2020))
((Infobox medical condition (new)
| name            = Discitis
| synonyms        =
| image           = Discitis.jpg
| caption         = Discitis in a 2 year old child.
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'''Discitis''', or '''diskitis''', is an [[infection]] in the [[intervertebral disc space]] that affects different age groups. Symptoms include severe back pain, leading to lack of mobility. In adults, it can lead to severe consequences, such as [[sepsis]] or [[epidural abscess]], but it can also spontaneously resolve, especially in children under 8 years of age. Discitis occurs post-surgically in approximately 1–2 percent of patients after spinal surgery. There is debate as to the cause. Diagnosis is usually apparent on [[MRI]], although plain X-rays and [[CT scan|CT examinations]] can be suggestive. Treatment usually includes [[antibiotic]]s, and reducing the mobility of the affected region.

== Description ==
Discitis is an [[infection]] in the [[intervertebral disc space]]. It affects different age groups.

==Signs and symptoms==
Symptoms include severe back pain, leading to lack of mobility. In adults, it can lead to severe consequences, such as [[sepsis]] or [[epidural abscess]], but it can also spontaneously resolve, especially in children under 8 years of age. Discitis occurs post-surgically in approximately 1–2 percent of patients after spinal surgery. Some very young children may refuse to walk and arching of the back is possible. In post-operative situations, the symptoms occur within a week and result in severe low back pain or neck pain (depending on the surgical location).

If untreated, the discitis may resolve on its own, causing spontaneous fusion of the intervertebral disc space, cause a chronic low grade infection, or progress to [[osteomyelitis]] and possibly even an [[epidural abscess]]. In case of concomitant inflammation of one or more vertebrae (in such cases usually involving the areas adjacent to the intervertebral disc spaces)<ref>[https://books.google.com/books?id=VRnFkfvRT4EC&pg=PA147 Page 147] in:((cite book |author1=Hinchcliffe, Ronald |author2=Fritz Hefti |author3=Jundt, Gernot |author4=Freuler, F. |title=Pediatric Orthopedics in Practice |publisher=Springer |location=Berlin |year=2007|isbn=978-3-540-69963-7 ))</ref> the condition is called [[spondylodiscitis]].

==Causes==
There is debate as to the cause, although hematogenous seeding of the offending organism is favored as well as direct spread. Spontaneous discitis is usually from [[hematologic]] spread from a urinary or respiratory infection while discitis from a [[Post-operative infection|post-operative complication]] usually involves [[skin flora]] such as [[Staphylococcus aureus|staph aureus]]. It can be caused due to [[spinal tuberculosis]] and spread along spinal ligament to involve the adjacent anterior vertebral bodies, causing angulation of the vertebrae with subsequent [[kyphosis]].<ref>((cite book | chapter-url=https://www.elsevier.com/books/davidsons-principles-and-practice-of-medicine/walker/978-0-7020-5035-0 | title=Davidson's Principles & Practice of Medicine |edition=22nd | publisher=Elsevier | editor1=Brian R. Walker | editor2=Nicki R. Colledge | editor3=Stuart H. Ralston | editor4=Ian D. Penman | year=2014 | chapter=Respiratory disease | author1=P.T. Reid | author2=J.A. Innes | pages=692 | isbn=9780702050473))</ref> The cause may be [[aseptic]].<ref>((Cite journal |last1= Langlois |first1= S |last2= Cedoz |first2= JP |last3= Lohse |first3= A |last4= Toussirot |first4= E |last5= Wendling |first5= D |display-authors= 4 |title= Aseptic discitis in patients with ankylosing spondylitis: A retrospective study of 14 cases |journal= Joint, Bone, Spine: Revue du Rhumatisme |volume= 72|issue= 3 |pages= 248–53 |year= 2005 |pmid= 15850997 |doi= 10.1016/j.jbspin.2004.05.015))</ref>

==Diagnosis==
[[File:Pinfecteddisc.png|thumb|An infected disc at the level of C5 C6 causing neurological symptoms]]((Unreferenced section|date=June 2023))
Diagnosis is usually apparent on [[MRI]], although plain X-rays and [[CT scan|CT examinations]] can be suggestive. The MRI will reveal air changes in the disc and possibly even external involvement involving the bone or [[Epidural space|epidural regions]]. A [[biopsy]] may be performed and helps with diagnosis in some cases but often an organism is not obtained. [[C-reactive protein]] levels and [[Erythrocyte sedimentation rate|ESR levels]] will be elevated and are useful for treatment. Often, the [[white blood cell count]] will be normal and the patient will be [[afebrile]].

==Treatment==
Treatment usually includes [[antibiotic]]s, and reducing the mobility of the affected region, either with a [[back brace]] or a [[plaster cast]]. Without treatment, the patient may form an [[abscess]] which may need to be surgically corrected.<ref>((Cite web |last=MD |first=Dave Harrison |date=2022-12-31 |title=Discitis: Definition, Causes, Symptoms, Diagnosis, Treatment, and Prognosis |url=https://www.spineinfo.com/conditions/discitis/discitis-definition-causes-symptoms-diagnosis-treatment-and-prognosis/ |access-date=2024-03-10 |website=Spine Info |language=en-US))</ref> Due to the poor [[vascularity]] of the disc, drugs required for treatment often include potent agents such as [[Ciprofloxacin]] along with [[Vancomycin]]. Occasionally, oral drugs can be used to treat the infection but it may fail and IV drugs may be required.

If the patient is an adult, many surgeons and doctors now recommend moving little and often and within the pain limits of the medication. Discs respond to [[osmotic pressure]] therefore movement is beneficial to increase their blood flow and fluid dynamics. In children, whether to bed rest or move a little is decided on an individual basis, depending on the site and severity of the discitis.

==References==
((reflist))

== External links ==
((Medical resources
|  DiseasesDB     = 3847
|  ICD10          = ((ICD10|M|46|4|m|45))
|  ICD9           = ((ICD9|722.90))
|  ICDO           =
|  OMIM           =
|  MedlinePlus    = 000993
|  eMedicineSubj  = article
|  eMedicineTopic = 1263845
|  MeshID         = D015299
))

((Dorsopathies))

[[Category:Infectious diseases]]
[[Category:Vertebral column disorders]]

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