What causes diskitis?

Updated: May 13, 2020
  • Author: Alvin Marcovici, MD; Chief Editor: Jeffrey A Goldstein, MD  more...
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Answer

Diskitis is thought to spread to the involved intervertebral disk via hematogenous spread of a systemic infection (eg, urinary tract infection [UTI]). Many sites of origin have been implicated, but UTI, pneumonia, and soft-tissue infection seem to be the most common. Direct trauma has not been conclusively shown to be related to diskitis. Intravenous (IV) drug use with contaminated syringes offers direct access to the bloodstream for a variety of organisms. Often, no other site of infection is discovered.

Staphylococcus aureus is the organism most commonly found; however, Escherichia coli and Proteus species are more common in patients with UTIs. Pseudomonas aeruginosa and Klebsiella species are other gram-negative organisms observed in IV drug abusers, although they are not seen as commonly as S aureus. Not surprisingly, medical conditions that predispose patients to infections elsewhere in the body are associated with diskitis. Diabetes, AIDS, steroid use, cancer, and chronic renal insufficiency are common comorbidities. [1]

Although rare, infection of the disk space can also occur following surgical intervention at the site. The infection rate after anterior cervical diskectomy has been quoted at 0.5% of cases; the infection rate for lumbar diskectomy is half that. In such cases, infection is transmitted through direct inoculation of the operative site. As in spontaneous diskitis, the most common organism is S aureus, but Staphylococcus epidermidis and Streptococcus species also should be considered.

Childhood diskitis has not been consistently associated with an initial causative infection elsewhere in the body. S aureus is the most common organism found.


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