Der Orthopäde
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Spinal infections are rare, occurring most often in elderly patients with urinary tract infections or diabetes. With the increasing number of patients with immune suppression, and also the increasing number of immigrants in the population, spinal infections are seen more frequently, especially in young adults. Typically spinal infections are monomicrobial, Staphylococcus aureus being the most common organism. ⋯ Important diagnostic measurements are laboratory studies, radiological evaluation including MR image scans, and CT-guided percutaneous biopsy of the lesion for microbiological studies. The management of spinal infections consists of antimicrobial therapy over 6-8 weeks. Surgical intervention is indicated in neurologically compromised patients for spinal instability and abscesses.
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Joint infections represent a surgical emergency. For diagnosis, clinical, sonographic, and radiographic examinations are required. ⋯ Therapy consists in administration of antibiotics, arthroscopic or open debridement with joint lavage, postoperative drainage and early active and passive mobilization of the joint without weight bearing. Early surgical revision is recommended in cases of insufficient recovery.