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复杂布氏杆菌性脊椎骨髓炎:来自流行地区的经验。

Complicated brucellar spondylodiscitis: experience from an endemic area.

机构信息

Department of Infectious Disease and Clinical Microbiology (IDCM), Erciyes School of Medicine, Talas-Kayseri, Turkey,

出版信息

Rheumatol Int. 2013 Nov;33(11):2909-12. doi: 10.1007/s00296-012-2555-5. Epub 2012 Nov 4.

Abstract

The demographical, clinical, and therapeutical features of patients with brucellar spondylodiscitis (BS) were evaluated in this study. Of the 96 patients with brucellosis, 20 (20.8%) were diagnosed with spondylodiscitis. Patients who had BS were more likely to be older (p = 0.001), have higher erythrocyte sedimentation rates (p = 0.01), and more likely to be anemic (p = 0.017). Lumbar segment (18/20) was frequently involved region. BS was complicated with paravertebral or epidural abscess in seven, radiculitis in six, and psoas abscess in five of cases. Antibiotic regimens including two or three antibiotics with combination of doxycycline, rifampin, and streptomycin were used. In this series, the mean duration of antimicrobial therapy was 18 weeks (range 12-56 weeks). Attention is drawn to this disease given the need for prolonged duration of treatment especially in complicated cases in order to avoid possible sequelae.

摘要

本研究评估了布鲁氏菌性脊椎骨髓炎(BS)患者的人口统计学、临床和治疗特征。在 96 例布鲁氏菌病患者中,20 例(20.8%)被诊断为脊椎骨髓炎。患有 BS 的患者年龄更大(p = 0.001)、红细胞沉降率更高(p = 0.01)且更易贫血(p = 0.017)。腰椎段(18/20)是最常受累的部位。BS 并发椎旁或硬膜外脓肿 7 例,神经根炎 6 例,腰大肌脓肿 5 例。抗生素方案包括两种或三种抗生素,联合使用多西环素、利福平、链霉素。在本系列中,抗菌药物治疗的平均持续时间为 18 周(范围 12-56 周)。鉴于需要长期治疗,特别是在复杂病例中,以避免可能的后遗症,需要引起对这种疾病的重视。

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