Andrés Soto1, Alberto Fica2, Jeannette Dabanch2, Felipe Olivares3, Lorena Porte4. 1. Servicio de Infectología, Departamento de Medicina, Hospital Militar de Santiago, Chile, andresfsoto@gmail.com. 2. Servicio de Infectología, Departamento de Medicina, Hospital Militar de Santiago, Chile. 3. Facultad de Medicina, Universidad de los Andes, Chile. 4. Laboratorio de Microbiología, Departamento de Medicina, Hospital Militar de Santiago, Chile.
Abstract
BACKGROUND: Spondylodiscitis (SD) involves long periods of hospitalization, diagnostic latency and risk of long-term complications. No updated series are available in Chile and a change in demographic features and etiology is suspected. AIM: To characterize a group of patients with SD. PATIENTS AND METHODS: Clinical series including patients over an 8 year period. RESULTS: We identified 37 patients; 37.8% women and 62.2% men (mean age 66.8 years); 64.9% were elderly; 35.1% had diabetes and 21.6% urological comorbidity. Main symptoms were pain and fever. Erythrocyte sedimentation rate was elevated in 89.2%, and 86.5% patients had MRI, which was always confirmatory. Lumbar spine was the most common site of infection (43.2%). Etiology was identified in 28/37 patients: 71.4% yielded grampositive cocci (Staphylococcus aureus predominantly), Mycobacterium tuberculosis was identified in only 10.7%. Staphylococcus aureus was associated to medical comorbidities (p < 0,05) and gramnegative bacilli to hepatobiliar or intestinal symptoms (p < 0,05). Culture obtained by a surgical procedure had the highest yield. The average duration of antibiotic therapy was 63.8 days (IQR 53-72). Treatment-related side effects were detected in 18.9% of patients. The average hospital stay was 38.9 days. No deaths occurred during hospitalization. Motor sequelae were present in 18.9% of this series. DISCUSSION: Most patients with SD were older adults. Staphylococcus aureus was predominant and M. tuberculosis was uncommon. Antibiotic side effects were relevant as well as the neurological complications.
BACKGROUND:Spondylodiscitis (SD) involves long periods of hospitalization, diagnostic latency and risk of long-term complications. No updated series are available in Chile and a change in demographic features and etiology is suspected. AIM: To characterize a group of patients with SD. PATIENTS AND METHODS: Clinical series including patients over an 8 year period. RESULTS: We identified 37 patients; 37.8% women and 62.2% men (mean age 66.8 years); 64.9% were elderly; 35.1% had diabetes and 21.6% urological comorbidity. Main symptoms were pain and fever. Erythrocyte sedimentation rate was elevated in 89.2%, and 86.5% patients had MRI, which was always confirmatory. Lumbar spine was the most common site of infection (43.2%). Etiology was identified in 28/37 patients: 71.4% yielded grampositive cocci (Staphylococcus aureus predominantly), Mycobacterium tuberculosis was identified in only 10.7%. Staphylococcus aureus was associated to medical comorbidities (p < 0,05) and gramnegative bacilli to hepatobiliar or intestinal symptoms (p < 0,05). Culture obtained by a surgical procedure had the highest yield. The average duration of antibiotic therapy was 63.8 days (IQR 53-72). Treatment-related side effects were detected in 18.9% of patients. The average hospital stay was 38.9 days. No deaths occurred during hospitalization. Motor sequelae were present in 18.9% of this series. DISCUSSION: Most patients with SD were older adults. Staphylococcus aureus was predominant and M. tuberculosis was uncommon. Antibiotic side effects were relevant as well as the neurological complications.
Authors: Edwin Bernard; Brenda Enelis; Renat Nurmukhametov; Manuel de Jesus Encarnacion Ramirez; Medet Dosanov; Ilya Shirshov; Ibrahim E Efe; Issael Jesus Ramirez Pena; Rossi E Barrientos Castillo Journal: Cureus Date: 2022-07-29