OBJECTIVES: To characterize a series of patients with Infectious Spondylodiscitis (IS). MATERIAL AND METHODS: Retrospective analysis of all cases diagnosed between October of 1999 and April of 2006 in our hospital, by files review. RESULTS: Forty one patients, mean age of 61.2 +- 15.1 years; 26 (63.4%) were male. Thirty two (78.0%) had predisposing conditions or associated diseases and 12 (29.3%) had epidemiological risk. The most frequent clinical manifestations were local pain (97.6%) and general complaints (51.2%). The mean duration of the symptoms was 12.5 weeks. Raised erythrocyte sedimentation rate was the most frequent inflammatory marker. CT-scan was diagnostic in 3 cases and MRI in the remainders. IS was most frequent in the lumbar spine. The etiological agent was isolated in 22 patients (53.7 %) and in 4 (9.8%) the diagnosis was serological. The diagnosis of Pyogenic Spondylodiscitis (PS) was presumed in 21 (51.2%) cases, Granulomatous Spondylodiscitis (GS) in 18 (43.9%) and GS with pyogenic over infection in 2 (4.9%). Fourteen patients had other infectious foci. All patients had antibiotic treatment. Two patients needed abscess CT-scan guided drainage and five needed surgery. Twenty six patients (63.4%) had good evolution and 8 (19.5%) had reasonable evolution; 6 patients had bad evolution (14.6%), dying; one patient was lost for follow-up. Inflammatory markers decreased in the control analysis. CONCLUSIONS: The IS is a diagnostic and therapeutic challenge, being the high index of suspicion of this pathology in the most susceptible patients fundamental for early detection and adequate treatment.
OBJECTIVES: To characterize a series of patients with Infectious Spondylodiscitis (IS). MATERIAL AND METHODS: Retrospective analysis of all cases diagnosed between October of 1999 and April of 2006 in our hospital, by files review. RESULTS: Forty one patients, mean age of 61.2 +- 15.1 years; 26 (63.4%) were male. Thirty two (78.0%) had predisposing conditions or associated diseases and 12 (29.3%) had epidemiological risk. The most frequent clinical manifestations were local pain (97.6%) and general complaints (51.2%). The mean duration of the symptoms was 12.5 weeks. Raised erythrocyte sedimentation rate was the most frequent inflammatory marker. CT-scan was diagnostic in 3 cases and MRI in the remainders. IS was most frequent in the lumbar spine. The etiological agent was isolated in 22 patients (53.7 %) and in 4 (9.8%) the diagnosis was serological. The diagnosis of Pyogenic Spondylodiscitis (PS) was presumed in 21 (51.2%) cases, Granulomatous Spondylodiscitis (GS) in 18 (43.9%) and GS with pyogenic over infection in 2 (4.9%). Fourteen patients had other infectious foci. All patients had antibiotic treatment. Two patients needed abscess CT-scan guided drainage and five needed surgery. Twenty six patients (63.4%) had good evolution and 8 (19.5%) had reasonable evolution; 6 patients had bad evolution (14.6%), dying; one patient was lost for follow-up. Inflammatory markers decreased in the control analysis. CONCLUSIONS: The IS is a diagnostic and therapeutic challenge, being the high index of suspicion of this pathology in the most susceptible patients fundamental for early detection and adequate treatment.
Authors: Enrique Marco de Lucas; Andrés González Mandly; Agustín Gutiérrez; Raúl Pellón; Laura Martín-Cuesta; Javier Izquierdo; Elena Sánchez; Eva Ruiz; Fernando Quintana Journal: Clin Rheumatol Date: 2008-11-29 Impact factor: 2.980