Management of nontuberculous infectious discitis. Treatments used in 110 patients admitted to 12 teaching hospitals in France

Legrand, Érick; Flipo, René‐Marc; Guggenbuhl, Pascal; Masson, Charles; Jf, Maillefert; Soubrier, M; Noël, É.; Saraux, Alain; Fazano, C. Scotto Di; Sibilia, Jean; Goupille, Philippe; Chevalier, Xavier; Cantagrel, Alain; Conrozier, Thierry; Ravaud, Philippe; Lioté, Frédéric

doi:10.1016/s1297-319x(01)00315-3

Cited by 130 publications

(116 citation statements)

References 2 publications

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“…Some other authors also have similar and even higher percentages [15,21]. However, since staphylococcus was the most common micro-organism, responsible for the infection in 14 cases (60.9%) in our study, and also in most publications [2,4,5,14,19], antibiotic treatment should be empirically instituted early [5]. Furthermore, staphylococcal bacteriaemia should be promptly prevented if a local infection in the intravenous catheters appears, with either cloxacillin or, if a methicillin resistant staphylococcus is suspected, with vancomycin plus rifampicin.…”

Section: Discussionsupporting

confidence: 81%

Spondylodiscitis in patients under haemodyalisis

Cerván

Colmenero²,

Arco

et al. 2011

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to reach conclusions about the diagnosis and treatment of a series of patients with spondylodiscitis under haemodialysis treatment. Methods We collected and studied 23 patients included in a prospective database from two neighbouring hospitals. Descriptive statistical analysis was performed. Results The diagnosis was frequently made very late and early negative cultures were not uncommon; magnetic resonance images allowed for an early diagnosis with accurate anatomical information. Empirical antibiotic treatment with prompt surgery produced good results in patients under risk of, or having neurological problems. Surgical approaches did not differ from pyogenic or tuberculous spondylodiscitis. Age in our series was not a predictive issue. Conclusions Whenever a patient under haemodialysis has symptoms of spinal disease, particularly back pain with fever, they should undergo an MRI. If diagnosis of spondylodiscitis is made prompt empirical antibiotherapy should be instituted. Blood cultures should be performed and tissue samples taken for cultures; however, culture outcome must not delay therapy. Early surgical decompression leads to good results.

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Section: Discussionsupporting

confidence: 81%

Spondylodiscitis in patients under haemodyalisis

Cerván

Colmenero²,

Arco

et al. 2011

International Orthopaedics (SICOT)

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“…The most commonly identified microorganism was S. aureus, both in blood cultures and percutaneous bone biopsy cultures, which is consistent with the results reported by Mylona et 3,[18][19][20] . There was no difference in total duration of therapy, but patients with complicated VO were longer treated parenterally and more often surgically for epidural phlegmon and abscess formation.…”

Section: Discussionsupporting

confidence: 90%

Vertebral Osteomyelitis in Adult Patients – Characteristics and Outcome

Mustapić

Višković

Borić³

et al. 2016

ACC

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SUMMARY -The aim of the study was to assess disease characteristics and outcome in patients with vertebral osteomyelitis (VO). A two medical centre retrospective cohort study was performed by chart review after discharge of 110 patients with confirmed VO treated during a 5-year period. Patients were divided in two groups: patients with uncomplicated VO and patients with complicated VO. All patients underwent clinical and biological examinations and magnetic resonance imaging (MRI) according to the same protocol. Patients with complicated VO were significantly older (p=0.038). They were longer treated with antibiotics parenterally (p=0.047) and more often surgically (p<0.001). In these patients, high Charlson comorbidity index (CCI) score was more often observed (p=0.024), as well as liver cirrhosis (p=0.013) and degenerative spine disease (p=0.007) as comorbidities. Patients with advanced MRI changes of VO had a modified CCI score of 2 or more (p=0.006). They more often experienced neurological deficit (p=0.021). Staphylococcus aureus was the most frequently isolated bacterium from blood and tissue samples. Advanced MRI changes and complicated VO were more often observed in patients with high CCI score due to impaired immune system caused by chronic comorbid disease(s) or modulation of immunity with medications. High CCI scores were more frequently associated with positive blood cultures due to bacteremia because of impaired immunity. Patients with complicated VO were longer treated with antibiotics parenterally and more often surgically treated for phlegmon and abscess formation. Liver cirrhosis and degenerative spine disease, which were more often found in patients with complicated VO, obviously impacted the course of the disease.

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“…1 Recent years have seen an increase in direct mechanisms of infection after surgery, epidural or spinal puncture procedures and their frequency varies in some series to 25 -30%. 18,22 …”

Section: Pathogenesismentioning

confidence: 99%

“…1 Gram-negative microorganisms in patients with SS are isolated in 7-33%, as the most common species are Escherichia coli, Proteus spp., Klebsiella spp, Enterobacter spp and Pseudomonas aeruginosa. [22][23][24][25]27,28 The latter are associated with gastrointestinal or urinary infection, diabetes mellitus, immunosuppressive and adult patients. 1,4 Coagulase-negative staphylococci cause spinal infection in 5-16%.…”

Section: Cause Of Infectionmentioning

confidence: 99%

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Spontaneous Spondylodiscitis - Epidemiology, Clinical Features, Diagnosis and Treatment

2017

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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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Management of nontuberculous infectious discitis. Treatments used in 110 patients admitted to 12 teaching hospitals in France

Cited by 130 publications

References 2 publications

Spondylodiscitis in patients under haemodyalisis

Spondylodiscitis in patients under haemodyalisis

Vertebral Osteomyelitis in Adult Patients – Characteristics and Outcome

Spontaneous Spondylodiscitis - Epidemiology, Clinical Features, Diagnosis and Treatment

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