Aseptic HLA B27-positive spondylodiscitis: decreased 18F-FDG uptake after etanercept treatment

Cases report: spondylodiscitis and epiduritis after suffering COVID - 19

Background. The review analyzes a possible rare complication of COVID-19 in the form of spondylodiscitis, including with developed epiduritis, in patients who have undergone COVID-19 with severe pneumonia, respiratory failure and systemic inflammatory response syndrome (SIRS). Clinical Case Description. Based on our own clinical observations, an approach to the diagnosis and treatment of three patients is described, each of whom had SIRS, severe fever, a significant increase in laboratory markers of inflammation (C - reactive protein (CRP), leukocytosis, erythrocyte sedimentation rate (ESR), fibrinogen, procalcitonin , ferretin), the addition of bacterial pneumonia, pronounced disorders of coagulation hemostasis, the development of spondylodiscitis, despite the wide range of previous antibiotic therapy, acute pain in the lumbar spine (LSP) with features of "red flags". In the first patient, against the background of massive antibiotic therapy, revisions of purulent foci, glucocorticosteroid (GCS) therapy, and surgical treatment, there was a significant positive trend in the form of pain relief. The second patient showed positive dynamics against the background of conservative antibiotic therapy. The third patient, with a paravertebral abscess at the level of developed spondylodiscitis, received massive antibiotic therapy in combination with GCS, and was operated on to decompress the spinal cord. Conclusion. The authors note that spondylodiscitis and epiduritis may be some of the possible complications of COVID-19 and / or the result of the unwanted action of drugs used to treat this disease. In this regard, timely diagnosis and treatment of this pathology in COVID - 19 seems to be very relevant

Spine Infections: the role of Fluorodeoxyglucose Positron Emission Tomography (FDG PET) in the context of the actual diagnosis guideline

Spondylodiscitis is an infectious process that requires numerous health care professionals to be clearly diagnosed and eventually successfully treated. It implies a variety of microbiological agents and conditions; during the diagnostic workup, it is difficult to correctly identify them, and the clinician has to rapidly choose the correct treatment to avoid permanent injuries to the patient. In this context, we conducted a review to better understand the most suitable use of Positron Emission Tomography with 18-Fluoro-deossi-glucose (FDG PET) in a patient suspected of spondylodiscitis, based on current guidelines and literature.. We wanted to review the role of FDG PET in the spondylodiscitis diagnosis and follow up in the context of the current guidelines.