LOZANO A, JIMENEZ-MEJIAS E, SANCHEZ-LORA J, PALOMINO J, PACHON J, COLMENERO J; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 681 (abstract no. 1526).
Complejo Hosp. Carlos Haya, Malaga, SPAIN
BACKGROUND: Tuberculosis is still a matter of concern and a great public health problem in many countries. Tuberculous vertebral osteomyelitis (TVO) is one of the most frequent extrapulmonary locations. OBJECTIVE: To study the current epidemiologic, clinical, diagnostic and therapeutic features and outcome of TVO.METHODS: A multicenter, descriptive, retrospective study of 293 cases of spondylitis attended in two universitary Spanish hospitals with uniform protocols from January 1982 to December 1998.RESULTS: Of total spondylitis, 55 were tubercolous (18.8%). Sex: 28 males(51%). Age: 50+/- 18.5(13-84). Six (11%)cases were diabetic, 11 (20%) had inmunosupression or other debilitating diseases, five (9%) were intravenous drug abusers, one of them also HIV+. Diagnostic delay was 24.7+/-23.2 weeks. Clinical features: back pain 48 (87%), fever 20 (37,7%), neurological impairment 38 (69%), paraparesis 15 (27%), paraplegia 4 (7%). Vertebral levels affected: Dorsal 26 (48%), D12-L1 6 cases (11%), lumbar 16 (29.6%), L5-S1 4 cases (7,3%), and different levels 2 (3.7%). In 28 cases (58,3%) Mycobacterium tuberculous complex was isolated from vertebral biopsy, in 9 cases (16%) from cultures of other samples; in 36 cases the vertebral biopsy showed caseating granulomas and in 6 cases diagnosis was based on clinical, radiological and therapeutic response. In 5 cases (5,5%) no radiological procedure suggested VO. There were paravertebral masses in 40 cases (74%), intrarachidian masses in 38 (69%) and psoas abscess in 11 (20%). Surgery was needed in 43 cases (78%), 11 of them because of medical treatment failure. Hospital stay was 7.1+/-4.9 weeks. Severe functional impairment: 25 patients (48%). Crude mortality was 7,3%, but no attributable mortality was found.CONCLUSIONS: Diagnostic delay of TVO is still large despite improvement of diagnostic procedures. As a result, a great number of patients present neuroaxis compression, require surgical treatment, long hospital stay and suffer functional sequelae.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Back Pain
- HIV Seropositivity
- Humans
- Male
- Osteomyelitis
- Psoas Abscess
- Retrospective Studies
- Spine
- Spondylitis
- Tuberculosis
- Tuberculosis, Osteoarticular
Other ID:
UI: 102246404
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