Spontaneous disc space XXXX in adults.

@entity1 @entity66 @entity6 @entity1512 @entity1514 @entity281 @entity86
BACKGROUND: @entity1512 typically affects @entity1 ; much less is known about the disease in adults. We examined the clinical characteristics and the role of surgery in spontaneous @entity1512 in adults. METHODS: Twenty-nine consecutive adult @entity1 (16 @entity1 , 13 @entity1 ) with spontaneous @entity1512 were treated by a single surgeon (MJE) over a 5-year period. These @entity1 were compared to 19 consecutive @entity1 with @entity86 over the same time period. Mean follow-up was 2.4 years. RESULTS: The average age of @entity1 with spontaneous @entity1512 was 69.0 years. Eleven of these @entity1 (38%) were @entity6 and 9 (31%) had a known concurrent @entity281 . @entity281 occurred at cervical (10%), @entity1514 (34%), and lumbar interspaces (59%), and at multiple disc spaces in eight cases (28%). Ten @entity1 (34%) had an elevated serum leukocyte count and 21 @entity1 (72%) had an elevated erythrocyte sedimentation rate. While Gram-positive @entity281 was most common, a broad spectrum of microbes was isolated. All @entity1 were treated with i.v. antibiotics for a mean duration of 6 weeks. Four @entity1 required surgical fusion; the rest were treated with external immobilization. At follow-up, 21 @entity1 (72%) were symptom-free, 3 @entity1 (10%) had @entity66 , and 5 @entity1 (17%) had died of unrelated causes. Compared to @entity1 with @entity86 treated over the same time period, spontaneous @entity1512 in adults affected older @entity1 and required a broader spectrum of antibiotic coverage. Outcomes were similar between the two groups. CONCLUSIONS: While spontaneous @entity1512 has predominantly been reported in @entity1 , the disease also affects older adults. @entity1512 in adults is associated with advanced age, @entity6 , and @entity281 . Elevated serum leukocyte count lacks diagnostic sensitivity. A high cure rate is achieved with antibiotics and external immobilization. Surgical treatment is rarely required.
