Aspectos clínicos e terapêuticos da osteomielite vertebral por fungos: análise secundária de dados

Abstract

Objectives: to assess the bibliometric, clinical and therapeutic features of fungal vertebral osteomyelitis case reports, retrieved from electronic databases. Methods: systematic review with secondary data analysis done on proven cases from Medline, Embase and Lilacs databases and active search of referenced published reports, since 1966 until 2004. Results: there was a growing trend from 1966 to 2004 (R 2 = 0.5518) in the 318 retrieved cases of fungal vertebral osteomyelitis: 218/318 (68.5%) of them from 1990 on. Reports with diagnosis from North America prevailed (148/318 [46.5%]). The most common causative agent was Candida spp (131/318 [41.2%]), followed by Aspergillus spp (102/318 [32.1%]). Time elapsed between symptom appearance and diagnosis ranged from one week to 9.6 years, mean 24.4±41.6 weeks. The lumbar-sacral spine was the most affected segment (188/318 [59.1%]), and the cervical spine was involved in only 24/318 descriptions (7.5%). The combination L2+L3 was the most frequent infectious event (35/318 [11%]); L2 and L3 were the most affected vertebrae (84/318 [26.4%]). Surgical treatment was carried out in 194/307 (63.2%) cases. Arthrodesis was the surgical procedure performed in 91/307 (29.6%) with clear notification. There was a growing trend of azole compound utilization, in substitution to amphotericin B, between 1966-1989 (10/37) and 1990-2004 (40/63). Conclusion: fungal vertebral osteomyelitis has been more frequently reported since the 1990s. Great attention to the possibility of this diagnosis is necessary so that the fungal vertebral infection is not missed due to the lack of a routine mycological search in a general microbiology laboratory.

Spinal Cord Paracoccidioidomycosis: Case Report

“…13,23 Besides intramedullary spinal cord involvement, intradural extramedullary granulomas may occur, as well as epidural bone lesions involving the spinous process, the lamina and the vertebral bodies, causing osteomyelitis and spondylodiscitis. [24][25][26][27][28] There is evidence that the concomitant use of corticosteroids with antifungal therapy can reduce the inflammatory process in patients with PCM. 2 The drugs most used in the antifungal treatment are itraconazole, sulfamethoxazole/trimethoprim, and amphotericin B.…”

“…13 23 Besides intramedullary spinal cord involvement, intradural extramedullary granulomas may occur, as well as epidural bone lesions involving the spinous process, the lamina and the vertebral bodies, causing osteomyelitis and spondylodiscitis. 24 25 26 27 28…”

Vertebral Osteomyeli̇t Konulu Yayinlarin Bi̇bli̇yometri̇k Anali̇z Yöntemi̇ İle İncelenmesi̇

“…Espec ally the ncrease n the poss b l t es n the f eld of rad ology prov des fac l tates d agnos s. Although there s a l m ted number of b bl ometr c analyzes for spec f c VO publ cat ons n the ava lable l terature [24][25][26][27] , no study provd ng an overv ew was found. In th s study, we a med to g ve a v s on to those who w ll work on VO w th the b blometr c analys s method over the Scopus database.…”

Impacto das internações por osteomielite: Uma avaliação da prevalência e gravidade

“…Uma vez dentro do osso, as bactérias proliferam e desencadeiam uma resposta inflamatória, resultando em destruição do tecido ósseo (LEW & WALDVOGEL, 2004;HEITZMANN et al, 2019). Outras causas menos comuns podem incluir infecções fúngicas ou parasitárias (FIGUEIREDO et al, 2007).…”