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Pediatric Discitis is an intervertebral disc infection due to hematogenous spread to vascular channels in cartilage that disappear later in life. In 1/3 of patients it is caused by S. aureus.
Presenting Features
- age <2.5 years (75%)
- Refuse or difficult to walk (56%)
- Back/neck pain (25-45%) ( 100%>3years)
- Hx of fever (28-47%)
- lumbaosacral area (78-82%)
- Mean ESR 39-42
- WBC> 10,500 (50%)
- Abnormal MRI 90-100 %
Management is to exclude more severe disease (osteomylelitis,abscess, tumor) and antibiotic use is debatable. Remember children this age rarely complain of back pain.
References
Pediatrics 2000; 105: 1299