Yasar Kadriye, Pehlivanoglu Filiz, Cicek Gulten, Sengoz Gonul
Department of Clinical Microbiology and Infectious Diseases, Haseki Training and Research Hospital, Istanbul, Turkey.
J Neurosci Rural Pract. 2012 Jan;3(1):17-20. doi: 10.4103/0976-3147.91925.
In this study, the evaluation of the clinical, laboratory and radiological findings belonging to 55 cases that were hospitalized in our clinic to be followed-up and were diagnosed with tuberculous, brucellar and pyogenic spondylodiscitis (SD) was aimed.
The cases with SD were evaluated retrospectively. Hematological, serological, biochemical laboratory tests and imaging technics were used for diagnosis.
Of 55 cases aged ranging between 25 to 79, 33 (59%) were female. The cases with tuberculous SD (TBSD), brucellar SD (BSD) and pyogenic SD (PSD) were found in 24 (43%), 12 (21%) and in 19 (34%) patients. Erytrocyte sedimentation rate, increased C-reactive protein, and leucocytosis were present in 51 (91%), 22 (39%) and 8 (14%) cases. The number of the cases with history of previous surgery or trauma was 14 (25%). Diagnosis of TBSD was established by acid fast bacilli positiveness and Löwenstein Jensen culture positiveness, in two and seven patients, respectively. While all 12 cases with BSD had positive standard tube aglutination test, only 3 (25%) had hemoculture positivity. In PSDs, diagnosis was confirmed with culture positivity in 9 of 19 cases.Of the cases in our study, 89% responded to medical treatment while three required surgery and three died (5.5% and 5.5%, respectively).
SD may develop secondary to infections or following spinal surgical procedures and traumas. Also, the importance of endemicity should be kept in mind, beside the helpful diagnostic findings while treatment regulation.
本研究旨在评估我院收治的55例需随访且诊断为结核性、布鲁氏菌性和化脓性脊椎椎间盘炎(SD)患者的临床、实验室及影像学检查结果。
对SD患者进行回顾性评估。采用血液学、血清学、生化实验室检查及影像学技术进行诊断。
55例患者年龄在25至79岁之间,其中33例(59%)为女性。结核性SD(TBSD)、布鲁氏菌性SD(BSD)和化脓性SD(PSD)患者分别有24例(43%)、12例(21%)和19例(34%)。51例(91%)患者红细胞沉降率升高,22例(39%)患者C反应蛋白升高,8例(14%)患者白细胞增多。既往有手术或外伤史的患者有14例(25%)。分别有2例和7例患者通过抗酸杆菌阳性和罗氏培养基培养阳性确诊为TBSD。12例BSD患者标准试管凝集试验均为阳性,仅3例(25%)血培养阳性。19例PSD患者中9例通过培养阳性确诊。本研究中,89%的患者对药物治疗有反应,3例需要手术,3例死亡(分别为5.5%和5.5%)。
SD可能继发于感染或脊柱手术及外伤后。此外,在制定治疗方案时,除了有助于诊断的检查结果外,还应牢记地方流行性的重要性。