The evaluation of the clinical, laboratory and the radiological fi ndings of the fi ft y-fi ve cases diagnosed with tuberculous, brucellar and pyogenic spondylodiscitis

Yaşar, Kadriye Kart; Pehlivanoğlu, Filiz; Çiçek, Gülten; Şengöz, Gönül

doi:10.4103/0976-3147.91925

Cited by 16 publications

(16 citation statements)

References 15 publications

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“…20,21 In our series, a definitive etiologic diagnosis was achieved in 60% of the patients, in agreement with the literature that describes values between 49% and 83%, with higher rates in acute rather than chronic disease. 26 Since in 26% of cases a presumptive etiologic diagnosis was achieved, the overall rate ascended to 86%, a higher rate than reported in the literature.…”

Section: Microbiologic and Serologic Evaluationsupporting

confidence: 91%

Infectious Spondylodiscitis

Lebre¹,

Vélez²,

Rabadão³

et al. 2014

Infectious Diseases in Clinical Practice

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Backgrounds: Spondylodiscitis (SD), which encompasses vertebral osteomyelitis, spondylitis, and discitis, is a pathology lacking consensus on optimal management.Methods: This was a retrospective analysis of medical records of all patients with diagnosis of SD admitted in an infectious diseases department, over a 24-year period (1988Y2011). Demographic, clinical, etiologic, radiological, and therapeutic data were collected.Results: One hundred forty patients were enrolled, mostly male (63%), with mean age 57 years (range, 17Y83 years), with average hospital stay of 46 days (range, 1Y190 days). Most frequent complaints were pain (96%), fever (46%), and neurological impairment (26%). Average duration of symptoms was 4.5 months (range, 3 days to 48 months). Magnetic resonance imaging was the imaging technique more often performed, showing compatible abnormalities in 115 of 116 patients, with the lumbar vertebrae predominantly involved (55%). In 60% of cases, a definitive diagnosis was achieved (Brucella spp: 47; Staphylococcus aureus: 19; other bacteria: 11; Mycobacterium tuberculosis: 7; Candida albicans: 1). Etiology was presumed in 26% and undetermined in 14% of patients. Overall, the most prevalent was brucellar SD (39%), followed by tuberculous SD (24%) and pyogenic SD (23%). Most patients (96%) were managed medically, with regimens varying according to etiology and treatment response. Outcome was mostly favorable (82%), whereas 5% of patients died, and 10% were lost to follow-up. The remainder exhibited no clinical improvement.Conclusions: Results confirmed that an older population is mainly affected, and nonspecific manifestations lead to significant diagnostic delay. Prolonged antibiotherapy and targeted surgery appear to improve long-term prognosis. In Portugal, like other Mediterranean countries, brucellosis and tuberculosis were frequently implicated.

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Section: Microbiologic and Serologic Evaluationsupporting

confidence: 91%

Infectious Spondylodiscitis

Lebre¹,

Vélez²,

Rabadão³

et al. 2014

Infectious Diseases in Clinical Practice

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“…The prognosis is generally good in SD [31]. Ninety-four (87.8%) patients had recovered fully, thirteen (12.1%) had recovered with neurologic abnormalities, and none of the patients died.…”

Section: Resultsmentioning

confidence: 93%

“…SD is often found as a complication of psoas abscess and epidural abscess [30]. Of all SD cases, 25% are associated with epidural abscesses [31]. In this review, 26 patients had paravertebral abscesses, 34 (31.7%) had epidural abscesses, and 12 (11.2%) had psoas abscesses.…”

Section: Resultsmentioning

confidence: 99%

Spondylodiscitis: evaluation of patients in a tertiary hospital

Kaya

Ercan

Kaya

et al. 2014

J Infect Dev Ctries

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Introduction: Spondylodiscitis (SD) is an uncommon but important infection. The aim of this work was to study the risk factors, bacteriological features, clinical, laboratory and radiological findings of SD, and to shed light on the initial treatment. Methodology: A total of 107 patients who underwent treatment for SD were evaluated. The diagnosis of SD was defined by clinical findings, complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum tube agglutination (STA) test, Ziehl-Neelsen staining, culture, histopathology, and radiological methods such as magnetic resonance imaging (MRI) and computed tomography (CT) scans. Results: Of the 107 cases, ranging between 17 to 83 years of age, 64 (59.8%) were male. Twenty-seven (25.2%) patients had diabetes mellitus. Laboratory investigations revealed elevated CRP in 70 (65%) patients, elevated ESR in 65 (61%) patients, and elevated white blood cell (WBC) counts in 41 (38.3%) patients. Thirty-six (33.6%) patients were identified as having brucellar SD, and 5 (4.7%) patients were identified as having tuberculous SD. A total of 66 (61.6%) patients were determined to have pyogenic SD. The most frequently isolated microorganism was Staphylococcus aureus. Antibiotic therapy was given intravenously to all pyogenic SD patients. Conclusions: The incidence of SD has increased as a result of the higher life expectancy of older patients with chronic debilitating diseases and the increase of spinal surgical procedures. In patients with low back pain, SD should be considered as a diagnosis. For effective treatment, it is important to determine the etiology of the disease.

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“…In a previously published Turkish studies on VOM, nearly one-third of the patients had ST/PD [10,15,16]. In a large case series from Spain including 219 patients with VOM, ST/PD constituted approximately one-fifth of the patients [5].…”

Section: Discussionmentioning

confidence: 97%

The course of spinal tuberculosis (Pott disease): results of the multinational, multicentre Backbone-2 study

Batırel

Erdem

Şengöz

et al. 2015

Clinical Microbiology and Infection

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We aimed to describe clinical, laboratory, diagnostic and therapeutic features of spinal tuberculosis (ST), also known as Pott disease. A total of 314 patients with ST from 35 centres in Turkey, Egypt, Albania and Greece were included. Median duration from initial symptoms to the time of diagnosis was 78 days. The most common complications presented before diagnosis were abscesses (69%), neurologic deficits (40%), spinal instability (21%) and spinal deformity (16%). Lumbar (56%), thoracic (49%) and thoracolumbar (13%) vertebrae were the most commonly involved sites of infection. Although 51% of the patients had multiple levels of vertebral involvement, 8% had noncontiguous involvement of multiple vertebral bodies. The causative agent was identified in 41% of cases. Histopathologic examination was performed in 200 patients (64%), and 74% were consistent with tuberculosis. Medical treatment alone was implemented in 103 patients (33%), while 211 patients (67%) underwent diagnostic and/or therapeutic surgical intervention. Ten percent of the patients required more than one surgical intervention. Mortality occurred in 7 patients (2%), and 77 (25%) developed sequelae. The distribution of the posttreatment sequelae were as follows: 11% kyphosis, 6% Gibbus deformity, 5% scoliosis, 5% paraparesis, 5% paraplegia and 4% loss of sensation. Older age, presence of neurologic deficit and spinal deformity were predictors of unfavourable outcome. ST results in significant morbidity as a result of its insidious course and delayed diagnosis because of diagnostic and therapeutic challenges. ST should be considered in the differential diagnosis of patients with vertebral osteomyelitis, especially in tuberculosis-endemic regions. Early establishment of definitive aetiologic diagnosis and appropriate treatment are of paramount importance to prevent development of sequelae.

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The evaluation of the clinical, laboratory and the radiological fi ndings of the fi ft y-fi ve cases diagnosed with tuberculous, brucellar and pyogenic spondylodiscitis

Cited by 16 publications

References 15 publications

Infectious Spondylodiscitis

Infectious Spondylodiscitis

Spondylodiscitis: evaluation of patients in a tertiary hospital

The course of spinal tuberculosis (Pott disease): results of the multinational, multicentre Backbone-2 study

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