Infectious spondylitis is a rare but serious spinal infection, usually from bacteria or other germs. It’s most common after a medical procedure but could occur when an infection elsewhere in your body spreads to your spine.

Infectious spondylitis is an infection that develops in your spine, usually from bacteria. It’s rare, making up about 5% of all skeletal infections. Still, it could be a severe and potentially life threatening infection.

Prompt treatment is necessary, so it’s important to know the risk factors, symptoms, and when to contact a doctor. Here are the key facts you need to know about infectious spondylitis.

Language matters

You’ll notice that the language used to share stats and other data points is pretty binary, using “men” and “women.”

Although we typically avoid language like this, specificity is key when reporting on research participants and clinical findings.

Unfortunately, the studies and surveys referenced in this article didn’t report data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

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Spondylitis is a specific type of inflammation that commonly affects the spine. It’s a feature of certain autoimmune, inflammatory, and infectious diseases.

When you have infectious spondylitis, your spinal inflammation is due to an underlying infection. Pathogens that enter your bloodstream and travel to your spine may be the cause. Such infections include the following types:

  • Pyogenic: Most often involving bacterial infections, pyogenic spondylitis occurs when an infection has spread from another area of your body to your spine. Staphylococcus aureus (staph infections) and Escherichia coli (E. coli) are notable causes.
  • Tubercular: Also called Pott’s disease, spinal tuberculosis is spread via the blood to the spine. Sometimes, you may have spinal tuberculosis for several years before getting a diagnosis.
  • Fungal: While rare, Candida and other fungi can cause a spinal infection.
  • Parasitic: Rarer still, certain parasitic infections, such as toxoplasmosis, that affect your central nervous system may lead to a spinal infection.

These types of infections may occur as a result of the following:

  • recent surgery
  • placement of an epidural
  • dental procedure
  • intravenous drug use
  • use of vascular devices, such as catheters

Spondylitis vs. spondylodiscitis

Spondylitis and spondylodiscitis both affect your spine.

“Spondylitis” refers to inflammation of the spine more generally. Infectious spondylitis means an infection caused the inflammation in the body of your spine (vertebrae).

When the infection affects the vertebrae and the disks between them, doctors call this spondylodiscitis. This condition is also common in bone infections (osteomyelitis).

While the terms look similar, and people sometimes use them interchangeably, not all types of spondylitis are infections, and not all are spondylodiscitis.

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Infectious spondylitis is twice as common in men than in women. Researchers aren’t sure why, but it may be due to higher rates of risk factors among men.

This type of infection may also occur at any age, though it’s most common in adults. Pyogenic spondylitis is more common in older adults, but tubercular spondylitis is more common in younger adults.

Certain underlying conditions may increase your risk of developing infectious spondylitis. The most common is diabetes. Other conditions known to increase your risk include:

  • cancer
  • HIV
  • conditions that weaken your immune system

You also have a higher risk of developing infectious spondylitis if you take immunosuppressant drugs or use corticosteroids for a long time. Both these medications weaken your immune response.

Pain is the most common symptom of infectious spondylitis across all subtypes. Other symptoms may vary based on the type of infection you have.

Pain may extend from your back or neck to your abdomen, groin, and lower limbs. It may also be severe enough to keep you up at night.

You might also experience the following:

  • localized swelling and tenderness
  • fever
  • chills
  • night sweats

If the infection is from an incision, such as in the case of surgery, you may also experience drainage and redness around the affected area of skin.

Contact a doctor if you’re experiencing back pain, particularly if you have:

  • severe pain that does not respond to over-the-counter pain relievers
  • ongoing (chronic) pain that lasts 12 weeks or longer
  • pain accompanied by flu-like symptoms
  • any concerning symptoms after surgery

Aside from physical signs and symptoms, doctors may diagnose infectious spondylitis based on imaging tests of your spine. MRI is the most common.

A doctor may also take a vertebral biopsy. They often do this with the help of CT imaging.

A doctor may also order laboratory tests, such as blood work, to help identify the cause of your infection. Blood testing may also help confirm other health conditions, such as autoimmune diseases.

It may take several weeks, even months, to diagnose infectious spondylitis. Because symptoms like back pain are nonspecific, it’s possible to link them to other conditions, such as joint disease.

Infectious spondylitis often requires hospitalization. In the hospital, healthcare professionals can give you intravenous medications, such as antibiotics, antitubercular therapy, or antifungals, to treat the underlying cause.

Antimicrobial treatment may last 6 to 8 weeks, depending on the severity of the infection. Pyogenic infections may also require the use of long-term antibiotics.

In some cases, you may need surgery to treat some of the complications of spinal infections, such as bone damage, neurological side effects, or sepsis.

Is spondylitis contagious?

Infectious spondylitis is not contagious. Still, you can transmit the germs that caused the infection to others. The germs may affect other people differently.

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Experts estimate that infectious spondylitis is deadly in about 20% of all cases. The risk of dying from a spinal infection may be greater if you have a weakened immune system.

Prompt treatment can help prevent other complications of infectious spondylitis, including:

  • irreversible spinal damage
  • sepsis
  • neurological effects

Infectious spondylitis is an uncommon but serious type of infection. This spinal infection is most common in older adults, people with weakened immune systems, or people who recently had surgery. Severe back pain is the most common symptom.

It’s important for a doctor to determine the underlying cause of infectious spondylitis so you can get the appropriate treatment. Without proper treatment, spinal infections can lead to severe and potentially fatal complications.