Disk-space infection in children.

Disk-space infection and vertebral osteomyelitis are two separate entities. Disk-space infection is an isolated soft tissue infection usually caused by coagulase-positive S. aureus. There is reactive osteolytic and osteoblastic activity in the two adjacent vertebral end-plates. Treatment by immobilization alone usually produces a satisfactory outcome. A satisfactory outcome can be accomplished by bed rest or use of a corset or cast. Infrequently, needle biopsy or open biopsy may be necessary for the diagnosis and treatment of resistant disease; this usually is needed in an older child. Surgery and antibiotics are indicated in patients with persistent symptoms, persistent elevation of the sedimentation rate, and failure of the radiologic changes to improve. The findings and recommendations concerning children should not be applied to adults.