Criteria for disc space infection – one or more of the following:
(1) culture from a vertebral disc space taken at surgery or by needle aspiration is positive for micro-organisms
(2) evidence of vertebral disc space infection seen directly at a surgical operation
(3) evidence of vertebral disc space infection seen in histopathologic examination of a biopsy taken at surgery or needle biopsy
(4) all of the following:
(4a) one or both of the following:
(4a1) fever > 38°C
(4a2) pain at the involved vertebral disc space
(4b) no other recognized cause
(4c) one of the following
(4c1) positive antigen test on blood for common pathogenic bacteria
(4c2) positive antigen test on urine for common pathogenic bacteria
(4c3) radiographic evidence of infection in the disc space
where:
• Radiographic evidence of infection may include a positive readiolabel scan (gallium, technetium, other), CT scan, MRI or routine X-rays.
• Common pathogenic bacteria are Hemophilus influenzae, Streptococcus pneumoniae, Neisseria meningitides, and Group B Streptococcus.
• Antigen tests done on blood or urine are neither sensitive nor specific.
