Infectious spondylodiscitis: 5-year analysis of a tertiary hospital in Portugal

Ponciano, Ana; Cruz, Gonçalo; Ventura, Conceição; Rabadão, Eduardo; Cunha, José Saraiva da

doi:10.1080/23744235.2017.1419374

Cited by 5 publications

(2 citation statements)

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“…The average age of the patients was 47.20 years, similar to that reported by other African authors [14] [15] [16]. However, this means age was lower than that reported in the West [17] [18], where patients in their 50s and 60s are more commonly affected. This Open Journal of Rheumatology and Autoimmune Diseases to the observations of another study conducted in Lomé [12].…”

Section: Discussionsupporting

confidence: 83%

Profile of Infectious Spondylodiscitis in Rheumatology Consultation at University Teaching Hospital of Kara, Togo

Houzou¹,

Atake²,

Kakpovi³

et al. 2021

OJRA

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Objectives: The objective is to determine the frequency and the semiological and evolutionary profiles of infectious spondylodiscitis in hospital practice in Kara. Patients and methods: This was a cross-sectional study of a case series of patients with infectious spondylodiscitis, who were admitted to the rheumatology department of Kara University Hospital in North Togo. Results: Among the 3972 examined patients, 86 (33 males and 53 females) patients (2.16%) had infectious spondylodiscitis. The average age of these patients at the onset of the disease was 47.20 years. The average duration of the disease was 11.41 months. Tuberculosis was suspected in 77 of 86 patients (89.53%). The infectious spondylodiscitis most often affected the lumbar (51.04%) and dorsal (21.87%) segments and was associated with a pulmonary location in 31 patients (36.04%). In addition to underdevelopment and poor hygiene (72 cases), alcoholism (15 cases) and human immunodeficiency virus infection (10 cases) were the main risk factors identified. The progress with the medical treatment was favorable in 65 patients (75.58%) and 16 patients were lost to follow-up. Conclusion: The frequency of infectious spondylodiscitis reflects the underdevelopment and poor hygiene levels in Black Africa. Its etiology is most commonly associated with tuberculosis and remains a concern despite the epidemiological transition of the different diseases.

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Section: Discussionsupporting

confidence: 83%

Profile of Infectious Spondylodiscitis in Rheumatology Consultation at University Teaching Hospital of Kara, Togo

Houzou¹,

Atake²,

Kakpovi³

et al. 2021

OJRA

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“…Its annual incidence in Western countries is estimated at 0.4 to 2.4 per 100,000, with a trend toward an increase in number of cases probably due to population aging 1 . It is a potentially serious condition that can lead to neurological disorders, 2,3 septic complications, and even death. Thus, rapid diagnosis and appropriate management are essential.…”

mentioning

confidence: 99%

MRI Features Associated With the Detection of Microbial Pathogens by CT-Guided Biopsy in Septic Spondylodiscitis

Chotard¹,

Jacquier

Bart

et al. 2020

J Clin Rheumatol

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The aim of this study was to assess the magnetic resonance imaging (MRI) features associated with microbial pathogen detection by computed tomography (CT)-guided biopsy in patients with suspected septic spondylodiscitis.Methods: For the last 10-year period, we analyzed the medical records of patients who underwent MRI and CT-guided biopsy for suspected septic spondylodiscitis. Clinical characteristics were recorded. The following MRI features were assessed: edema or contrast enhancement of the intervertebral disc, adjacent vertebrae, epidural and paravertebral space, presence of abscess, and paravertebral edema size. A positive biopsy was defined by pathogen identification on bacterial analysis or the presence of granuloma on histology. Predictors of a positive biopsy were assessed with a logistic regression model. Results:We examined data for 61 patients (34 [56%] male; mean age, 59.9 ± 18.0 years); for 35 patients (57%), CT-guided biopsy was positive for a pathogen. The 4 MRI findings significantly associated with a positive biopsy were epiduritis, greater than 50% vertebral endplate edema, loss of intradiscal cleft, and abscess. The size of paravertebral edema was greater with a positive than negative biopsy (median, 15.9 [interquartile range, 11.3-21.3] vs 7.3 [4.6-12.9] mm; p = 0.004). On multivariable analysis, epiduritis was the only independent predictor of a positive biopsy (adjusted odds ratio, 7.4 [95% confidence interval, 1.7-31.4]; p = 0.006).Conclusions: Epiduritis and the size of paravertebral edema on MRI are associated with detection of a microbial pathogen in suspected septic spondylodiscitis. For patients without these MRI signs, the need for further investigations such as enriched or prolonged cultures, a second CT-guided biopsy, or even surgical biopsy need to be discussed.

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