Prise en charge d’une spondylodiscite infectieuse (hors mal de Pott)

Abstract

Management of vertebral osteomyelitis remains challenging and complex. Occurring mainly in elderly and frail patients, it needs a multidisciplinary approach with rheumatologists, infectious disease physicians, bacteriologists and surgeons. The corner stone of the management remains the antibiotics that are ideally introduced after bacterial identification. Initial clinical and imaging evaluation is necessary to decide the type and duration of immobilization. A rapid rehabilitation of the patient is necessary to prevent complications associated with the prolonged bed rest and its well-known morbidity. Presence of neurological complications or soft tissue abscesses are potential indications for surgery that needs to be discussed at the initial phase of the management and during the course of the disease. Finally, monitoring of the efficacy and tolerance of the therapy over the short, middle and long terms remains necessary to detect any possible sequelae. In the review, we will discuss each step of this management.