Pygonic spondylitis is a rare bacterial spinal infection that can cause pain and lead to neurological problems. Doctors often need an X-ray or MRI to confirm a diagnosis. But you may need to start antibiotic treatment before a diagnosis.

A pyogenic infection is any infection that causes pus to be produced. Spondylitis is a broad term that describes spinal diseases.

Pyogenic spondylitis is a type of pus-producing infection that affects the joints of your spine. It’s frequently due to bacterial infections that travel through your blood.

It’s not a very common condition, affecting about 0.5 to 2.2 out of every 100,000 people in the United States each year. But rates do seem to be rising, according to a 2018 study. It has the potential to be severe or even life threatening, especially if treatment is delayed.

The disease can cause temporary or permanent disability. This can include neurological problems because your spine is part of your central nervous system.

Anyone can have pyogenic spondylitis, but it tends to be about twice as common in males. Adults in their forties start to have an increased risk of pyogenic spondylitis, and the risk continues to grow as age increases. There are other risk factors that we’ll cover later in this article.

Let’s look more closely at the causes, treatments, and effects of pyogenic spondylitis.

Language matters

Sex and gender exist on spectrums. This article uses the terms “males” and “females” to refer to sex assigned at birth. Your gender identity may not align with how your body responds to this disease.

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Pyogenic spondylitis is due to bacteria that enter your bloodstream and then travel to your spine.

The bacterial strain most commonly associated with pyogenic spondylitis is Staphylococcus aureus. Another common bacterial cause is Escherichia coli (E. coli). It’s a leading cause of urinary tract infections, which can later move to your spine.

There are also reports of other types of bacteria, like Staphylococcus schleiferi or Streptococcus constellatus, causing pyogenic spondylitis, but these are rare.

Bacteria can get into your bloodstream through open cuts or sores, so it’s important to use appropriate bandages and change them regularly. Frequent handwashing can also help prevent infections.

Some medical procedures require direct access to your spine. Until these openings fully heal, they might provide a way for bacteria to reach your spine. These procedures could include:

Although the reason isn’t fully understood, pyogenic spondylitis is about twice as common in males than in females.

Most often, it affects people in their 40s. The chances of having pyogenic spondylitis increase every decade after that point.

Because it’s due to a bacterial infection, people with a weakened immune system have an increased risk of pyogenic spondylitis. Your immune system can be less effective as a result of some diseases. Certain treatments, such as chemotherapy, can also affect your immune system.

Having certain other medical conditions can also increase your risk of pyogenic spondylitis. These can include:

The most common symptoms of pyogenic spondylitis usually come on very suddenly and include:

  • spine pain
  • tenderness
  • fever
  • loss of range of motion

Other symptoms that you might experience if you have pyogenic spondylitis include:

For some people, there might not be many symptoms. This can make it more difficult to diagnose.

Based on your symptoms, a doctor or other healthcare professional may suspect you have an infection. Common tests a doctor might order include:


These above tests might provide clues to diagnose pyogenic spondylitis, but not always. Doctors will usually use these results along with imaging scans such as spine X-rays and magnetic resonance imaging (MRI).

Pyogenic spondylitis tends to damage the space between two bones in your spine called vertebrae. These scans can show two vertebrae compressed close together in the infected area with damage to your surrounding bone as well. This will generally lead to a diagnosis.

Pyogenic spondylitis vs. tuberculous spondylitis

Pyogenic spondylitis isn’t the only kind of infection you can have in your spine.

Tuberculosis is another infection that can affect your bones and joints, including your spine. While the symptoms and tests may be similar, tuberculous spondylitis is due to various species of mycobacterium, such as Mycobacterium tuberculosis.

Tuberculous spondylitis usually takes longer for symptoms to become noticeable than pyogenic spondylitis, but only a thorough examination can determine which condition you have.

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If a doctor suspects you might have pyogenic spondylitis, it’s common to begin treatment with antibiotics before you receive a diagnosis. After confirming a diagnosis, they might adjust the types or amounts of antibiotics.

You can expect to receive intravenous (IV) antibiotics before eventually switching to oral antibiotics. Experts haven’t determined how long you should be on antibiotics, but you can expect somewhere from 4–8 weeks.

Because of the structural damage to your spine, you might also need bed rest to relieve pressure and reduce pain. You might also need to wear a cast for several weeks or even months to help your spine heal in the correct position.

It’s not very common, but some people do need surgical treatment for pyogenic spondylitis. This is usually to help relieve pressure on your spinal cord, which might cause neurological symptoms.

If you have pyogenic spondylitis, your outlook is generally better the sooner you can begin treatment.

About 1 in 4 people with pyogenic spondylitis experience neurological symptoms, while less than 1 in 10 have permanent neurological issues.

About 1 in 3 people with pyogenic spondylitis will have some permanent disability from the infection.

Completing your prescribed antibiotic treatment can help reduce your likelihood of recurrence (repeat infection). Recurrence becomes rare about 6 months after completing antibiotics, but happens during the antibiotic treatment in up to 22% of people.

About 6 months after completing antibiotics, many people report a significant improvement in back pain.

Bacteria can sometimes get into your bloodstream. When they do, they can make their way to your spine, where they can infect your bones and surrounding tissues. Many different bacteria can do this.

Some bacterial strains, especially S. aureus, can cause pyogenic spondylitis. This disease mostly affects adults beginning in their 40s.

If you believe you’re at risk of pyogenic spondylitis and are experiencing symptoms, consult a medical professional. Early treatment is one of the most effective tools for an improved outcome.