Evaluation of empirical antibiotic treatment in culture-negative pyogenic vertebral osteomyelitis

Doğan, Mustafa; Şimşek, Abdullah Talha; Yılmaz, İbrahim; Karaarslan, Numan

doi:10.5137/1019-5149.jtn.25018-18.2

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…In human medicine, suspected infectious diseases with negative tissue culture, such as spondylodiscitis, vertebral osteomyelitis, sepsis, endocarditis and periprosthetic joint infections, have been widely reported ( 30 – 34 ). In our study, 10 out of 12 dogs in which discospondylitis was treated surgically, had an IVD sample taken.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Preliminary Assessment of Routine Follow-Up Low-Field Magnetic Resonance Imaging in Dogs Presumptively Diagnosed With Discospondylitis

Freitas¹,

Vettorato²,

Scarpante³

et al. 2022

Front. Vet. Sci.

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BackgroundThe usefulness of routine follow-up Magnetic Resonance Imaging (MRI-2) in asymptomatic dogs treated for discospondylitis is unknown.MethodsThis cross-sectional retrospective study investigated the features of MRI-2 in a heterogeneous group of dogs treated for discospondylitis, and if these were associated with the presence or absence of clinical signs. After comparing initial MRI (MRI-1) and MRI-2, an observer, blinded to the dog's clinical signs, described the MRI-2 findings. The study population was then divided into symptomatic or asymptomatic at the time of MRI-2. Two separate observers subjectively classified the discospondylitis as active or inactive. Repeatability and interobserver agreement were evaluated.ResultsA total of 25 dogs were included. At the time of MRI-2 16 (64%) dogs were asymptomatic and 9 (36%) were symptomatic. Based on MRI-2, 20 (80%) and 18 (72%) out of 25 dogs were considered to have active discospondylitis by the first and second observers, respectively. Interobserver agreement was moderate. No MRI-2 features were associated with the clinical status. The subjective classification of inactive discospondylitis was significantly associated with asymptomatic clinical status, but the classification of active discospondylitis was evenly distributed between groups.ConclusionThis study did not identify a meaningful association between the clinical status of dogs treated for presumptive discospondylitis and MRI-2 results. There were no specific MRI-2 features which were associated with the clinical status.

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Section: Discussionmentioning

confidence: 99%

Retrospective Preliminary Assessment of Routine Follow-Up Low-Field Magnetic Resonance Imaging in Dogs Presumptively Diagnosed With Discospondylitis

Freitas¹,

Vettorato²,

Scarpante³

et al. 2022

Front. Vet. Sci.

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“…There is no clear treatment guideline for SEA with negative bacterial culture, and such treatment mainly depends on empirical medication. 23 With the increase of culture-negative patients in clinical practice, 24 it is more and more important to improve the understanding and clinical treatment of negative SEA culture. The vast majority of our cases (in the literature and in our present study) are caused by Gram-positive cocci, mainly S. aureus (67%).…”

Section: Figurementioning

confidence: 99%

<p>Studies on 11 Cases of Spinal Epidural Abscess and Literature Review</p>

Dai

Yin

et al. 2020

IDR

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In the present study, we aimed to describe the clinical features, diagnosis, treatment, and prognosis of spinal epidural abscess (SEA). Methods: The complete clinical data of 11 SEA patients who were treated in our hospital system from January 2015 to June 2018 were retrospectively analyzed. Moreover, the clinical features, diagnosis, treatment, and prognosis of 642 SEA cases collected from the foreign literature from 2010 to 2019 were also investigated. Results: Among our 11 SEA patients, nine cases had purulent inflammation, two cases had tuberculosis, two cases had infection caused by Staphylococcus aureus, one case had infection caused by Streptococcus constellatus, one case had infection caused by Klebsiella pneumoniae, five cases showed negative bacterial culture, and two cases had Mycobacterium tuberculosis. All 11 cases showed focal spinal pain, eight cases exhibited neurological deficits, and six cases experienced fever. Nine of the 11 cases involved the lumbosacral spine, one case involved the thoracic spine, and one case involved the cervical spine. Eight patients had a longer course of disease (>2 weeks), all 11 patients had vertebral osteomyelitis, and nine patients had intervertebral discitis. One patient had motor dysfunction of arms and legs, one patient had lower limb motor dysfunction, one patient had limb numbness, one patient experienced relapse after the conservative treatment, and one patient experienced relapse after the surgical treatment. The follow-up time was 15-24 months. Conclusion: The classic diagnosis of triads (focal spine pain, neurological deficit, and fever) was less specific for SEA. MRI examination, blood culture, tissue culture, and biopsy could be used for the diagnosis for SEA. Suppuritis was a common cause of SEA. Early detection, early diagnosis and early treatment, as well as the selection of the most suitable treatment regimen based on comprehensive evaluation, played crucial roles in a better prognosis of SEA. There was no statistically significant difference in terms of the general condition, diagnosis, treatment and prognosis between the patients with negative and positive culture results (P>0.05). For SEA patient with negative culture, antibiotic treatment should be used empirically.

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“…Studies have reported the clinical features and results of culture-negative purulent spondylitis [7]. However, the treatment of patients with culture-negative purulent spondylitis mainly relies on empirical medication [8], and there is no established standard Treatment principles. It is increasingly important to improve the understanding and clinical treatment of culture-negative purulent spondylitis.…”

Section: Introductionmentioning

confidence: 99%

Culture-negative versus culture-positive in pyogenic spondylitis and analysis of risk factors for relapse

Dai

Yin

et al. 2021

British Journal of Neurosurgery

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This study aims to compare and analyze the clinical features, diagnosis, treatment and prognosis of culture-negative and culture-positive primary pyogenic spondylitis. Methods A retrospective analysis of 202 cases of adult primary pyogenic spondylitis with complete clinical data in our hospital from January 2013 to January 2020 were divided into 2 groups according to the bacterial culture results: culture negative group (n = 126), culture Positive group (n = 76). Compare the clinical characteristics, diagnosis, treatment and prognosis of patients with different culture results. Results The culture positive rate was 37.62% (76/202). There were no signi cant differences in age, gender, affected segment, spinal abscess, diabetes mellitus, course of disease, surgery, recurrence, and follow-up time between the two groups (P > 0.05). Two groups of hospital admission erythrocyte sedimentation rate (erythrocyte sedimentation rate, ESR), admission C-reactive protein (C-reactive protein, CRP), admission white blood cell count (white blood cell, WBC), discharge ESR, discharge CRP, ESR decline rate, CRP There were statistically signi cant differences in the rate of decline, hospitalization days, and body temperature ≥ 38 °C (P < 0.05). Higher CRP levels on admission, antibiotic treatment time < 6 weeks, and body temperature ≥ 38 ℃ are independent risk factors for infection recurrence. Conclusion The culture-negative group's admission WBC, admission ESR, admission CRP, discharge ESR, discharge CRP, ESR decline rate, CRP decline rate, and hospital stay were lower than the culture positive group, the difference was statistically signi cant (P < 0.05). The independent risk factors for infection recurrence are higher CRP levels in hospital admission, antibiotic treatment time < 6 weeks, and body temperature ≥ 38 °C.

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Evaluation of empirical antibiotic treatment in culture-negative pyogenic vertebral osteomyelitis

Cited by 4 publications

References 16 publications

Retrospective Preliminary Assessment of Routine Follow-Up Low-Field Magnetic Resonance Imaging in Dogs Presumptively Diagnosed With Discospondylitis

Retrospective Preliminary Assessment of Routine Follow-Up Low-Field Magnetic Resonance Imaging in Dogs Presumptively Diagnosed With Discospondylitis

<p>Studies on 11 Cases of Spinal Epidural Abscess and Literature Review</p>

Culture-negative versus culture-positive in pyogenic spondylitis and analysis of risk factors for relapse

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