Diagnostic Yield of CT-guided Percutaneous Aspiration Procedures in Suspected Spontaneous Infectious Diskitis

Chew, Felix S.; Kline, Mitchell

doi:10.1148/radiology.218.1.r01ja06211

Cited by 192 publications

(130 citation statements)

References 20 publications

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“…The reported accuracy of spinal biopsy varies from 36% to 91% according to the organism isolated [5,8,17,18,20,21]. In a retrospective study of postoperative spondylodiscitis, Fouquet et al obtained positive bacteriologic diagnoses in nine (36%) of 25 patients who had biopsies [8].…”

Section: Discussionmentioning

confidence: 99%

“…They concluded the features of septic or chemical postoperative discitis can be distinguished by ESR, CRP, and percutaneous discal biopsy. To evaluate the diagnostic yield of CT-guided percutaneous needle aspiration in spontaneous (nonpostoperative) infectious discitis, Chew and Kline divided 105 consecutive patients having CT-guided biopsies into two groups, 43 with active disc space infection and 62 without active disc space infection [5]. Microbiologic analyses of the CT-guided percutaneous aspiration specimens were positive in 39 (91%) of 43 patients with active infections.…”

Section: Discussionmentioning

confidence: 99%

“…Computed tomographic-guided biopsy for bacteriologic diagnosis has a variable rate of 36% to 91% reported accuracy in patients with spinal infections [5,8,17,18,20,21]. Percutaneous endoscopic discectomy and drainage (PEDD), a relatively new technique, is emerging because of its simplicity and apparent diagnostic accuracy from 45% to 87% according to the organism isolated [10,13,22].…”

Section: Introductionmentioning

confidence: 99%

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Identifying Pathogens of Spondylodiscitis: Percutaneous Endoscopy or CT-guided Biopsy

Yang

Chen

et al. 2008

Clinical Orthopaedics &Amp; Related Research

106

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Identifying offending pathogens is crucial for appropriate antibiotic administration for infectious spondylitis. Although computed tomography (CT)-guided biopsy for bacteriologic diagnosis is a standard procedure, it has a variable success rate. Some reports claim percutaneous endoscopic discectomy and drainage offer a sufficient amount of tissue for microbiologic examination and easy application. We therefore compared the diagnostic value of CT guidance with that of endoscope guidance in 52 patients with suspected infectious spondylitis. Twenty patients underwent percutaneous endoscopic discectomy and drainage by an orthopaedic surgeon and the other 32 patients underwent CT-guided biopsies by a radiologist. Patients were followed a minimum of 12 months after treatment. Culture results of the biopsy specimens were recorded. Causative bacteria were identified more frequently with percutaneous endoscopy than in CT-guided biopsy (18 of 20 [90%] versus 15 of 32 [47%]). We observed no biopsy-related complications or side effects in either group. The data suggest percutaneous endoscopic discectomy and drainage yield higher bacterial recovery rates than CT-guided spinal biopsy. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Identifying Pathogens of Spondylodiscitis: Percutaneous Endoscopy or CT-guided Biopsy

Yang

Chen

et al. 2008

Clinical Orthopaedics &Amp; Related Research

106

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“…The yield of microbiologic specimens obtained by CT-guided biopsy has been as high as 90% in a series of adults with infectious discitis. 34 In adults in whom there is a high suspicion of vertebral osteomyelitis, imagingguided percutaneous needle biopsy yielded a pathogen in 30.4% of cases but decreased to 5% in cases when malignancy was the initial working diagnosis in 1 study. 11 Imaging-guided aspiration/biopsy is being recognized as the standard of care in the diagnosis of vertebral osteomyelitis in adults and is currently endorsed by national guidelines.…”

Section: Figurementioning

confidence: 94%

Role of Operative or Interventional Radiology-Guided Cultures for Osteomyelitis

et al. 2016

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BACKGROUND AND OBJECTIVE: Acute hematogenous osteomyelitis (AHO) is a severe infection in children. Drainage of purulent collections in bones provides specimens for culture as well as therapeutic benefit. Interventional radiology (IR)-guided procedures may serve as a less invasive means of culture in select patients. We examined the impact of IR and surgically obtained cultures in the diagnosis and management of AHO.

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“…3,6,7 Mycobacterium tuberculosis, Brucella spp, Escherichia coli, Proteus spp Candida albicans, Kingella kingae, and Aspergillus spp are the other rare causes of spondylodiscitis. [10][11][12][13][14][15][16][17] The case described in this report is particularly interesting because of the causal organism and the setting of chronic renal failure. Spontaneous spondylodiscitis due to C. diptheria is extremely rare, and only two cases have been reported to date.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous corynebacterium discitis in a patient with chronic renal failure

et al. 2004

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Study design: Case report describing spontaneous Corynebacterium diptheria discitis in a patient with chronic renal failure. Objectives: To describe this very rare form of discitis and the results of surgical and antibiotic therapy. Setting: University Department of Neurosurgery, Turkey. Case report: A 55-year-old man with chronic renal failure presented with acute low-back pain. Lumbar magnetic resonance imaging (MRI) suggested discitis and osteomyelitis at the L5-S1 level. The L5-S1 disc was operated upon and the discectomy material was sent for pathological and microbiological analysis. Results: Pathological examination revealed infection and bacterial culture grew C. diptheria. The patient was prescribed combination antibiotic therapy with vancomycin, a third-generation cephalosporin, and rifampicin. Clinical status improved after 8 weeks of therapy. Lumbar MRI revealed remission of the discitis and osteomyelitis after 10 months of follow-up. Conclusion: Chronic renal failure patients with low-back pain should be investigated for spinal infection. These individuals are prone to low-grade infection in the form of discitis or osteomyelitis. Corynebacterium subspecies rarely cause spontaneous discitis. This case is interesting because of the unusual causal organism and the occurrence of discitis in the setting of chronic renal failure.

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Diagnostic Yield of CT-guided Percutaneous Aspiration Procedures in Suspected Spontaneous Infectious Diskitis

Abstract: CT-guided percutaneous needle aspiration is an accurate method for identifying active bacterial disk space infections but is less reliable for identifying fungal infections.

Cited by 192 publications

References 20 publications

Identifying Pathogens of Spondylodiscitis: Percutaneous Endoscopy or CT-guided Biopsy

Identifying Pathogens of Spondylodiscitis: Percutaneous Endoscopy or CT-guided Biopsy

Role of Operative or Interventional Radiology-Guided Cultures for Osteomyelitis

Spontaneous corynebacterium discitis in a patient with chronic renal failure

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