Recurrent spondylodiscitis secondary to hallux osteomyelitis

Authors

  • Aleksandra Staniszewska Department of Diabetes and Endocrinology, Ealing Hospital, London North West University Healthcare NHS Trust https://orcid.org/0000-0002-8917-1281
  • Elizabeth Ballingall Diabetes Specialist Podiatrist, London North West University Healthcare NHS Trust
  • Peter Schnatterbeck Department of Radiology, Ealing Hospital, London North West University Healthcare NHS Trust
  • Christopher R Lattimer Josef Pflug Vascular Laboratory, Ealing Hospital, London North West University Healthcare NHS Trust
  • Amit Amin Department of Microbiology, Ealing Hospital, London North West University Healthcare NHS Trust
  • William Lynn Department of Infectious Diseases, Ealing Hospital, London North West University Healthcare NHS Trust
  • Sanjeev Mehta Department of Diabetes and Endocrinology, Ealing Hospital, London North West University Healthcare NHS Trust

DOI:

https://doi.org/10.15277/bjd.2019.217

Keywords:

diabetes, foot ulcer, osteomyelitis, amputation, spondylodiscitis

Abstract

Foot infections are the commonest complication of diabetes mellitus requiring hospitalisation. Despite local osteomyelitis being the most frequent sequel of a diabetic foot infection, there is emerging evidence to suggest that local disease may lead to distant infections. In this report we present a case of recurrent thoracic spine spondylodiscitis due to left hallux osteomyelitis in a man with type 2 diabetes. This case illustrates the importance of considering spondylodiscitis as a differential diagnosis in patients presenting with diabetic foot infection and complaining of acute severe back pain.

References

Yazdanpanah L, Nasiri M, Adarvishi S. Literature review on the management of diabetic foot ulcer. World J Diabetes 2015;6:37–53. https://doi.org/10.4239/wjd.v6.i1.37

Ramsey SD, Newton K, Blough D, et al. Incidence, outcomes, and cost of foot ulcers in patients with diabetes. Diabetes Care 1999;22:382–7.

Jensen AG, Espersen F, Skinhoj P, Rosdahl VT, Frimodt-Moller N. Increasing frequency of vertebral osteomyelitis following Staphylococcus aureus bacteraemia in Denmark 1980–1990. J Infect 1997;34:113–18.

Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother 2010;65(Suppl 3):24. https://doi.org/10.1093/jac/dkq303

Shaho S, Khan S, Huda MS, Chowdhury TA. Metastatic spinal abscesses from diabetic foot osteomyelitis. BMJ Case Reports 2014 Jun 11; 2014.pii:bcr2014204816. doi: 10.1136/bcr-2014-204816.

Mantovani A, Trombetta M, Imbriaco C, et al. Diabetic foot complicated by vertebral osteomyelitis and epidural abscess. Endocrinol Diabetes Metab Case Rep 2016; 2016: 150132. Published online 2016 May 18. https://doi.org/10.1530/EDM-15-0132

Toyota T. Vertebral osteomyelitis in diabetes mellitus. Intern Med (Tokyo, Japan) 1997;36:382–3.

McHenry MC, Easley KA, Locker GA. Vertebral osteomyelitis: long-term outcome for 253 patients from 7 Cleveland-area hospitals. Clin Infect Dis 2002;34:1342–50. https://doi.org/1086/340102

Skaf GS, Domloj NT, Fehlings MG, et al. Pyogenic spondylodiscitis: an overview. J Infect Public Health 2010;3:5–16. https://doi.org/10.1016/j.jiph.2010.01.001

Bozkurt F, Gulsun S, Tekin R, Hosoglu S, Acemoglu H. Comparison of microbiological results of deep tissue biopsy and superficial swab in diabetic foot infections. J Microbiol Infect Dis 2011;1:122–7. https://doi.org/10.5799/ahinjs.02.2011.03.0028

Huang Y, Cao Y, Zou M, et al. A comparison of tissue versus swab culturing of infected diabetic foot wounds. Int J Endocrinol 2016; 2016:8198714. https://doi.org/10.1155/2016/8198714

Nelson A, Wright-Hughes A, Backhouse MR, et al. CODIFI (Concordance in Diabetic Foot Ulcer Infection): a cross-sectional study of wound swab versus tissue sampling in infected diabetic foot ulcers in England. BMJ Open 2018;8:e019437. https://doi.org/10.1136/bmjopen-2017-019437

Grammatico L, Baron S, Rusch E, et al. Epidemiology of vertebral osteomyelitis (VO) in France: analysis of hospital-discharge data 2002–2003. Epidemiol Infect 2008;136:653–60. https://doi.org/10.1017/S0950268807008850

Bhagat S, Mathieson C, Jandhyala R, Johnston R. Spondylodiscitis (disc space infection) associated with negative microbiological tests: comparison of outcome of suspected disc space infections to documented non-tuberculous pyogenic discitis. Br J Neurosurg 2007;21:473–7. https://doi.org/10.1080/02688690701546155

Lu YA, Hsu HH, Kao HK, et al. Infective spondylodiscitis in patients on maintenance hemodialysis: a case series. Renal Failure 2017;39:179–86. https://doi.org/10.1080/0886022X.2016.1256313

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Published

2019-06-27

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Section

Case Reports