Espondilodiscitis. Análisis de una serie de 25 casos

October 18, 2012 at 9:42 am

Revista médica de Chile Mayo 2003 V.131 N.5 P.473-482

Alberto Fica C, Francisca Bozán Pa, Magdalena Aristegui Va, Patricio Bustos G.

Background: Spondylodiscitis is a rare but prolonged inflammation of two adjacent vertebral bodies and the disk in between.

Aim: To report the clinical features of a series of patients with spondylodiscitis.

Material and methods: A retrospective analysis of medical records of patients with spondylitis, identified between 1989 and 2002.

Results: A total of 25 cases were identified, 15 female, aged 49.8 years as a mean. Their mean evolution before admission was 4.3 months. Main complaints were back or radicular pain. Mild anemia was present in most patients. Mean erythrocyte sedimentation rate and C reactive protein values were 66 mm/h and 60 mg/L, respectively. Forty four percent of patients had neurological complications. Vertebral computed tomography and scintigraphic studies were done in 72% of patients, but magnetic resonance imaging was done only in 4 (16%). In 18 patients, a tissue sample for pathological and microbiological analysis, was obtained by imaging guiding or surgically. Tuberculosis, diagnosed on pathology, was the leading cause of spondylitis in nine cases (36%), followed by Staphylococcus aureus infection in five (20%). Other agents found were E coli and group D Streptococcus (one each). Age, symptoms, evolution time and different laboratory parameters did not differ between patients with tuberculosis and patients with other causes. A microbiological cause was not established in 36% of cases. Most patients evolved satisfactorily and recovered from neurological complications (88%). One patient with tuberculosis did not improve after prolonged treatment and 2 patients infected with S aureus died (8%).

Conclusions: Spondylodiscitis is associated to a diversity of microbial agents and in most cases has a favorable prognosis.

FULL TEXT

http://www.scielo.cl/scielo.php?pid=S0034-98872003000500001&script=sci_arttext

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, F.O.D, Infecciones asociadas a catater IV, Infecciones del SNC, Infecciones e Insuf. renal, Infecciones en diabeticos, Infecciones osteo-articulares-musculares, Metodos diagnosticos, REPORTS, Update.

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