Recalcitrant Back Pain Could Be Vertebral Osteomyelitis

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Recalcitrant Back Pain Could Be Vertebral Osteomyelitis
Recalcitrant Back Pain Could Be Vertebral Osteomyelitis

(HealthDay News) -- Vertebral osteomyelitis should be considered in cases of back or neck pain unresponsive to conservative measures and elevated inflammatory markers with or without fever, according to new guidelines from the Infectious Disease Society of America published online July 29 in Clinical Infectious Diseases.

"Back pain is so common -- and usually not caused by infection -- that diagnosis often is missed or delayed," guidelines lead author Elie Berbari, M.D., of the Mayo Clinic College of Medicine in Rochester, Minn., said in a news release from the Infectious Diseases Society of America.

Vertebral osteomyelitis affects two to six out of 100,000 people a year. The condition develops when bacteria enter the blood stream and lodge in a spinal disc. The infection is most common in older people. "The infection causes severe pain that often wakes the person at night and does not go away after pain management or rest," Berbari said.

Elevated erythrocyte sedimentation rate or C-reactive protein can indicate vertebral osteomyelitis, and magnetic resonance imaging and biopsy can confirm it. Treatment typically involves six weeks of intravenous antibiotics. However, about half of patients may have to undergo surgery to remove the infection, Berbari said.

Several authors disclosed financial ties to the pharmaceutical and biotechnology industries.

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