Vertebral Osteomyelitis: Clinical Features and Diagnosis

July 1, 2017 at 4:10 pm

Clinical Microbiology and Infection April 2014

Şebnem Eren Gök1, Erkan Kaptanoğlu2, Aysel Çelikbaş1, Önder Ergönül3,*, Nurcan Baykam1, Mustafa Eroğlu1 andBaşak Dokuzoğuz1

Objective

We aimed to describe clinical and diagnostic features of vertebral osteomyelitis for differential diagnosis and treatment.

Methods

This is a prospective observational study performed between 2002 and 2012 in Ankara Numune Education and Research Hospital in Ankara, Turkey. All the patients with vertebral osteomyelitis were followed from six months to three years.

Results

In total 214 patients were included to the study, 113 out of 214 (53%) were female. Out of 214 patients, 96 (45%) were brucella vertebral osteomyelitis (BVO), 63 (29%) were tuberculous vertebral osteomyelitis (TVO), and 55 (26%) were pyogenic vertebral osteomyelitis (PVO). Mean days between onset of symptoms and establishment of diagnosis were longer with the patients TVO (266 days) than BVO (115 days) or PVO (151 days) (p<0.001). In blood cultures, Brucella spp was isolated among 35 out of 96 BVO patients (35%). Among 55 PVO patients, etiologic agent was isolated in 11 (20%) patients. For tuberculin skin test (TST) >15 mm, sensitivity was 0.66, specificity was 0.97, positive predictive value was 0.89, negative predictive value was 0.88, and ROC area was 0.8.

Conclusion

Tuberculous and brucellar vertebral osteomyelitis remained the leading causes of vertebral osteomyelitis with delayed diagnosis. In differential diagnosis of VO, consumption of fresh cheese, dealing with husbandry, sweating, arthralgia, hepatomegaly, elevated alanine transaminase, lumbar involvement in MRI were found to be predictors of BVO, thoracic involvement in MRI and TST> 15 mm were found to be predictors of TVO, and history of spinal surgery and leukocytosis were found to be predictors of PVO.

 

PDF

http://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)65378-7/pdf

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Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Biología Molecular, Epidemiología, F.O.D, Infecciones osteo-articulares-musculares, Infecciones relacionadas a prótesis, Infecciones sitio quirurgico, Metodos diagnosticos, Resistencia bacteriana, Sepsis, Update.

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