Diagnosis, management and outcome of clinically- suspected spinal infection

Luzzati, Roberto; Giacomazzi, Donatella; Danzi, Maria Chiara; Tacconi, Leonello; Concia, Ercole; Vento, Sandro

doi:10.1016/j.jinf.2009.02.006

Cited by 90 publications

(67 citation statements)

References 26 publications

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“…The differential diagnosis with PS is more difficult since blood cultures are negative in 30-40 % of PS cases [54,69] and CT-guided or open biopsy cultures have a diagnostic yield of 77 % [49]. In TS, the diagnostic yield of CT-guided biopsy and mycobacterial culture is around 75 % [11,44,49,52]. Histopathological analysis may also be useful.…”

Section: Diagnosis and Differential Diagnosismentioning

confidence: 99%

Bone and joint tuberculosis

2012

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Section: Diagnosis and Differential Diagnosismentioning

confidence: 99%

Bone and joint tuberculosis

2012

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“…Buna karşılık çalışmamız-daki olguların daha genç (ortalama yaş 51.71) olduğu göz-lendi. Son zamanlarda yapılan iki çalışmada yaş ortalaması, çalışmamıza benzer biçimde daha düşük olarak bulunmuştur (21,22). Daha önceki çalışmalara göre spondilodiskit, erkekleri kadınlara göre daha fazla etkilemektedir (3,15,19,23).…”

Section: İrdelemeunclassified

“…Çalışmamızda, en (23,28). TS olgularında nörolojik defisit oranı yüksek bulunmaktadır (15,21,22,29). BS olgularında ise nörolojik defisit daha nadir saptanmaktadır (21,22,30 tiksel olarak anlamlı bulunmadı (p=0.526).…”

Section: İrdelemeunclassified

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Tuberculous, Pyogenic and Brucellar Spondylodiscitis: Clinical and Laboratory Features of 103 Cases

Hamidi¹,

Özsüt²,

Başaran³

et al. 2015

Klimik Dergisi

2
1
1
0

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Objective: It was aimed to evaluate clinical and laboratory differences and characteristic aspects between cases that were classified in three subgroups as tuberculous spondylodiscitis (TS), pyogenic spondylodiscitis (PS) and brucellar spondylodiscitis (BS). Methods: Adult patients with spondylodiscitis diagnosis were evaluated retrospectively. Patients who had compatible epidemiological data with brusellosis and had Brucella tube agglutination test ≥1/160 or 4-fold increased titer two weeks later were diagnosed as BS. Cases with M. tuberculosis growth in the tissue samples and/or chronic granulomatous inflammation were diagnosed as TS. Cases in which diagnostic evaluation could not be made and clinical response was elicited with antituberculous treatment were also defined as TS. Cases in which pyogenic bacteria were isolated in samples or culture-negative cases that cured with antibiotic treatment were diagnosed as PS. Results: Among 103 patients there were 46 patients in TS, 37 in PS and 20 in BS groups. TS cases were younger (p=0.011) and had longer duration of complaints (p=0.044). Localized warmth and redness were observed more often and leukocyte counts, neutrophil counts, C-reactive protein levels and erythrocyte sedimentation rates were higher in PS (p<0.05). The thoracal involvement was most common in TS (41.3%) and lumbar in PS (67.6%). Sensitivity of determining causative organism was 56.7% for computerized tomography-guided percutaneous biopsy. Abscess formation was most frequent in TS and least in BS. Conclusions: Cervical or thoracal involvement with abscess formation and paravertebral spread in magnetic resonance imaging should be primarily considered as TS. Patients with previous spine surgery, localized warmth and redness on spine, elevated acute phase reactants and lumbar involvement should be considered as PS. Klimik Dergisi 2015; 28(2): 80-6. Key Words: Brucellosis, spondylitis, discitis, tuberculosis. ÖzetAmaç: Bu çalışmada tüberkülöz spondilodiskit (TS), pyojenik spondilodiskit (PS) ve Brucella spondilodiskiti (BS) olarak üçe ayrılan olguların, klinik ve laboratuvar özellikleri arasındaki farklılıkların ve özgün yönlerinin ortaya çıkarılması amaçlandı. Yöntemler: Spondilodiskit tanısıyla izlenmiş ≥18 yaş hastalar, geriye dönük olarak incelendi. Epidemiyolojik bilgileri sistemik brusellozla uyumlu olan ve serum Brucella tüp aglü-tinasyonu titresinin ≥1/160 olduğu veya iki hafta arayla dört kat arttığı saptananlara BS tanısı konuldu. Doku örneklerinde Mycobacterium tuberculosis üreyen ve/veya kronik granülo-matöz iltihap saptananlara TS tanısı konuldu. Tanısal girişim yapılamadığında tüberkülozu düşündüren bulguları ve antitüberküloz tedaviye yanıtı olanlar da TS olarak değerlendiril-di. Örneklerinde pyojenik bakteriler üremiş ya da antibiyotik tedavisine yanıt alınan kültür-negatif olgular, PS kabul edildi. Bulgular: 103 hastanın 46'sı TS, 37'si PS ve 20'si BS olarak tanımlandı. TS olguları daha gençti (p=0.011) ve yakınma süresi daha uzundu (p=0.044). PS grubunda, lokalize sı-cak...

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“…13,14 Several large prospective studies have found that no causative agent of SS is isolated in 21% -34% of the cases. 7,23,29,30,33 …”

Section: Cause Of Infectionmentioning
confidence: 99%

Spontaneous Spondylodiscitis - Epidemiology, Clinical Features, Diagnosis and Treatment
Petkova
¹
,
Zhelyazkov
²
,
Kitov
³

2017
Folia Medica
36
0
14
0
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Spontaneous spondylodiscitis is a rare but serious infectious disease which is a combination of an inflammatory process, involving one or more adjacent vertebral bodies (spondylitis), the intervertebral discs (discitis) and finally - the neighboring neural structures. In most cases the condition is due to a hematogenous infection and can affect all regions of the spinal cord, but it is usually localized in the lumbar area. The most common clinical symptom is a pronounced, constant and increasing nocturnal paravertebral pain, while consequently different degrees of residual neurological symptoms from nerve roots and/or spinal cord may appear. The disease course is chronic and the lack of specific symptoms often prolongs the time between its debut and the diagnosis. This delay in diagnosis determines its potentially high morbidity and mortality. Treatment is conservative in cases with no residual neurological symptoms and consists of antibiotic therapy and immobilization. Surgical treatment is necessary in patients with neurological deficit, spinal instability or drug resistance.

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Diagnosis, management and outcome of clinically- suspected spinal infection

Cited by 90 publications

References 26 publications

Bone and joint tuberculosis

Bone and joint tuberculosis

Tuberculous, Pyogenic and Brucellar Spondylodiscitis: Clinical and Laboratory Features of 103 Cases

Spontaneous Spondylodiscitis - Epidemiology, Clinical Features, Diagnosis and Treatment

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