Disease and Health Research: Recent Developments Vol. 2

Aims: To provide a practical, evidence-based approach to bacterial spondylodiscitis and to integrate current recommendations with the clinical experience of a tertiary infectious diseases centre.

Study Design: Narrative clinical review complemented by a retrospective descriptive case series.

Place and Duration of Study: Infectious Diseases clinical practice in Timișoara, Romania; the local series included 18 patients managed between 2024 and 2026.

Methodology: Current recommendations and recent literature on native vertebral osteomyelitis/spondylodiscitis were synthesised with emphasis on diagnostic microbiology, magnetic resonance imaging, antimicrobial treatment, surgical indications and follow-up. An anonymised retrospective dataset of 18 selected patients with bacterial spondylodiscitis was analysed descriptively. Continuous variables are reported as median and interquartile range (IQR) where appropriate, and categorical variables as numbers and percentages.

Results: Median age was 71 years [IQR 69-79], 72.2% of patients were women and 50.0% had diabetes mellitus. Back pain was present in all patients, whereas fever occurred in 27.8% and neurological deficit at diagnosis in 38.9%. Median time from symptom onset to diagnosis was 105 days [IQR 90-180]. Median initial C-reactive protein was 156 mg/L [IQR 145-189]. Blood cultures were positive in 4/18 patients (22.2%); documented pathogens included methicillin-resistant Staphylococcus aureus and extensively drug-resistant Klebsiella pneumoniae. MRI was performed in all cases. Paravertebral and psoas abscesses were recorded in 77.8% and 72.2%, respectively. All patients were treated conservatively, with a median of 30 days of intravenous therapy followed by oral treatment; total treatment duration was usually 12 weeks. Clinical improvement was recorded in all patients and no deaths were documented.

Conclusion: Spondylodiscitis requires early clinical suspicion, prompt MRI and active pursuit of microbiological aetiology. Stable patients should ideally undergo microbiological sampling before empirical antibiotics. Most uncomplicated bacterial cases can be treated for approximately 6 weeks, while longer courses may be appropriate in selected complicated patients. The local series highlights diagnostic delay, low frequency of fever and limited microbiological confirmation as practical challenges.