[Spinal infection with spinal cord/cauda equina affection requires emergency handling]

Lakartidningen. 2019 Nov 19:116:FPZX.
[Article in Swedish]

Abstract

Seventeen cases of infections in spinal structures were reported 2010-2017 to the Swedish Health and Social Care Inspectorate (IVO), a government agency responsible for supervising health care, for missed or delayed diagnosis. All patient records were scrutinized in order to find underlying causes and common factors. The delayed diagnoses were equally found among men and women and most frequent in in the age-group 65 to 79 years of age. The diagnostic delay most probably in many cases led to patient harm and avoidable sequelae, many with severe impairment for daily life. Several of the patients had a locus minoris resistentiae in the spine and in several cases the entry port of infections were cutaneous wounds, for example leg ulcers. The most important finding was that in the majority of cases the clinical investigation was inadequate and the clinical follow-up - while in hospital! - was inferior, without documentation of muscular weakness and sensory loss. In several cases a too passive management was found, when the losses eventually had become apparent, delaying surgical interventions.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cauda Equina Syndrome / complications
  • Cauda Equina Syndrome / diagnosis
  • Cauda Equina Syndrome / etiology
  • Cauda Equina Syndrome / therapy
  • Delayed Diagnosis
  • Diagnostic Errors
  • Discitis / complications
  • Discitis / diagnosis
  • Discitis / etiology
  • Discitis / therapy
  • Emergency Treatment
  • Female
  • Humans
  • Male
  • Osteomyelitis / complications
  • Osteomyelitis / diagnosis
  • Osteomyelitis / etiology
  • Osteomyelitis / therapy
  • Quality of Health Care / standards
  • Spinal Diseases* / complications
  • Spinal Diseases* / diagnosis
  • Spinal Diseases* / etiology
  • Spinal Diseases* / therapy
  • Spinal Stenosis / complications
  • Spinal Stenosis / diagnosis
  • Spinal Stenosis / etiology
  • Spinal Stenosis / therapy
  • Spondylitis / complications
  • Spondylitis / diagnosis
  • Spondylitis / etiology
  • Spondylitis / therapy
  • Thoracic Vertebrae
  • Time-to-Treatment