Infectious spondylodiscitis - a case series analysis.

PURPOSE: We aimed to describe the clinical and laboratory features as well as diagnostic difficulties in the case series of spondylodiscitis. MATERIALS/METHODS: We retrospectively reviewed 11 cases of spondylodiscitis. The diagnosis of spondylodiscitis was based on clinical, radiological and microbiological evidence and by the response to antimicrobial therapy. RESULTS: There were 7 men and 4 women, and the age ranged from 21 to 74 years. Risk factors of spondylodiscitis were observed in 7 patients. The approximate time from onset of symptoms to diagnosis was from 2 to 7 months (median 45 days). Back pain was the most common symptom. The most frequent location of spondylodiscitis was lumbar spine. Pathogens were isolated in 6 cases and were as follows: Staphylococcus aureus (4 cases), Staphylococcus warneri (1 case) and Escherichia coli (1 case). After therapy, all patients had rapid regression of symptoms and no permanent neurological impairments and recurrence of infection were observed. CONCLUSIONS: Diagnosis of spondylodiscitis is frequently delayed. This disease should be taken into consideration in differential diagnosis in patients with root syndromes accompanied by back pain and usually fever as well as increased values of CRP and ESR.

Vipera berus bites in Eastern Poland--a retrospective analysis of 15 case studies.

INTRODUCTION AND OBJECTIVE: The common European adder (Vipera berus) is the only venomous snake that is found naturally in Poland. This study presents the epidemiological and clinical characteristics of V.berus bites in Eastern Poland and describes the methods of poisoning treatment. MATERIALS AND METHODS: Medical documentation of 15 patients hospitalized at the Department of Infectious Diseases and Neuroinfections of the Medical University of Bialystok between 1998-2010 because of V.berus bite was analyzed retrospectively. RESULTS: Most of the snakebites were accidental (86.7% of the cases). The bites usually took place in forests (66.7% of the cases). The majority of patients were bitten in the lower extremity (8 cases, 53.3%), most often in the area of ankle joint. The severity of poisoning was usually minor to moderate. The most common local symptom was oedema (93.3% of the cases) and associated extravasations (73.3% of the cases). One patient experienced shock. Transient hypertension was observed in 3 cases. Mild coagulation disorders were present in 4 cases. In 4 cases, leukocytosis was observed. 86.7% of patients received the specific antivenom. No fatal outcome and no adverse reactions after antivenom administration were reported. CONCLUSIONS: In the majority cases of poisoning with V.berus venom, the poisoning takes a mild course, limited to local oedema, but sometimes it may lead to severe complications. The only specific method of the treatment is antivenom administration.