Discitis and spinal infection

Spinal infection poses a diagnostic challenge and a low threshold for investigation should be maintained. Presentation is varied and non-specific symptoms mean that patients are investigated by many specialities. The majority of spinal infection is from haematogenous spread and therefore an origin of infection needs to be sought. Treatment of spondylodiscitis is routinely managed by non-surgical treatment with a prolonged period of antibiotics. Complications of spondylodiscitis can lead to morbidity and may be difficult to treat and often require surgery. It is essential to attempt to obtain microbiological diagnosis. Initial management and investigation does affect treatment strategies and it is important to understand this.