STUDY DESIGN: Multicenter retrospective case series. OBJECTIVE: To determine relevant clinical presentation and outcome of human immunodeficiency virus (HIV)-positive patients with spondylodiscitis as a function of the treatment. SUMMARY OF BACKGROUND DATA: This is the first study comparing the clinical outcome of HIV-positive patients with spondylodiscitis as a function of the treatment. METHODS: We performed a national multicenter retrospective case series comparing operatively versus conservatively treated HIV-positive patients with spondylodiscitis presenting between 1991 and 2007. RESULTS: Twenty patients were included in the study. The average age of the patients at the time of admission was 43.0 years. The sex ratio m:w resulted in 2.3:1. On admission, 50% of the patients were in CDC stage C3. The CD4 T-cell count was determined as being 237.5/microL on average. At the occurrence of spondylodiscitis HIV had been known for a mean 8.5 years. In altogether 75% of the cases a pathogen was found. In 3 cases, mixed infections were present. Half of the patients received surgery. In none of these patients a wound infection or a delay of wound healing could be observed. One patient died during in-patient stay. Eleven of the 19 patients could be followed up a mean 13 months after discharge. In the follow-up period further 3 patients died on an average of 45 months after discharge. CONCLUSION: The occurrence of spondylodiscitis in HIV-positive patients is associated with a low CD4 T-cell count. The probability of mixed infections rises with a CD4 T-cell count <100/microL. The occurrence of spondylodiscitis in HIV-positive patients is accompanied by high mortality. Operative therapy of spondylodiscitis in HIV-positive patients is not associated with an increased surgical complication rate. HIV infection or AIDS should not have an influence on decision-making regarding conservative or operative therapy of spondylodiscitis.
STUDY DESIGN: Multicenter retrospective case series. OBJECTIVE: To determine relevant clinical presentation and outcome of human immunodeficiency virus (HIV)-positivepatients with spondylodiscitis as a function of the treatment. SUMMARY OF BACKGROUND DATA: This is the first study comparing the clinical outcome of HIV-positivepatients with spondylodiscitis as a function of the treatment. METHODS: We performed a national multicenter retrospective case series comparing operatively versus conservatively treated HIV-positivepatients with spondylodiscitis presenting between 1991 and 2007. RESULTS: Twenty patients were included in the study. The average age of the patients at the time of admission was 43.0 years. The sex ratio m:w resulted in 2.3:1. On admission, 50% of the patients were in CDC stage C3. The CD4 T-cell count was determined as being 237.5/microL on average. At the occurrence of spondylodiscitis HIV had been known for a mean 8.5 years. In altogether 75% of the cases a pathogen was found. In 3 cases, mixed infections were present. Half of the patients received surgery. In none of these patients a wound infection or a delay of wound healing could be observed. One patient died during in-patient stay. Eleven of the 19 patients could be followed up a mean 13 months after discharge. In the follow-up period further 3 patients died on an average of 45 months after discharge. CONCLUSION: The occurrence of spondylodiscitis in HIV-positivepatients is associated with a low CD4 T-cell count. The probability of mixed infections rises with a CD4 T-cell count <100/microL. The occurrence of spondylodiscitis in HIV-positivepatients is accompanied by high mortality. Operative therapy of spondylodiscitis in HIV-positivepatients is not associated with an increased surgical complication rate. HIV infection or AIDS should not have an influence on decision-making regarding conservative or operative therapy of spondylodiscitis.
Authors: Joseph T King; Adam J Gordon; Melissa F Perkal; Stephen Crystal; Ronnie A Rosenthal; Maria C Rodriguez-Barradas; Adeel A Butt; Cynthia L Gibert; David Rimland; Michael S Simberkoff; Amy C Justice Journal: Spine (Phila Pa 1976) Date: 2012-04-01 Impact factor: 3.468
Authors: Davis G Taylor; Avery L Buchholz; Durga R Sure; Thomas J Buell; James H Nguyen; Ching-Jen Chen; Joshua M Diamond; Perry A Washburn; James Harrop; Christopher I Shaffrey; Justin S Smith Journal: Global Spine J Date: 2018-12-13
Authors: Enrico Maria Bonura; David Joaquin Ortolà Morales; Domenico Fenga; Giuseppe Rollo; Luigi Meccariello; Danilo Leonetti; Francesco Traina; Francesco Centofanti; Michele Attilio Rosa Journal: Med Arch Date: 2019-02