Bellazreg Foued, Alaya Zeineb, Hattab Zouhour, Lasfar Nadia Ben, Ayeche Mohamed Laziz Ben, Bouajina Elyes, Letaief Amel, Hachfi Wissem
Service de Maladies Infectieuses, CHU Farhat Hached, Sousse, Tunisie.
Service de Rhumatologie, CHU Farhat Hached, Sousse, Tunisie.
Pan Afr Med J. 2016 May 3;24:3. doi: 10.11604/pamj.2016.24.3.8659. eCollection 2016.
Infectious sacroiliitis are rare but they can be complicated by disabling functional sequelae. To describe the clinical and bacteriological characteristics of infectious sacroiliitis among patients treated in Sousse Medical Center, Tunisia. A retrospective, descriptive study, of infectious sacroiliitis among patients hositalized in Sousse between 2000 and 2015. The diagnosis was made on the basis of medical signs, imaging, microbiological indicators. In the study were enrolled twenty five patients, 10 men and 15 women; the average age was 41 years (19-78). Sacroiliitis were due to pyogenic bacteria in 14 cases (56%), brucella bacteria in 6 cases (24%) and tuberculosis bacteria in 5 cases (20%). The mean duration of symptoms was 61, 45 and 402 days respectively. The most common clinical signs were buttock pain (92%) and fever (88%). Standard radiographic evaluation was abnormal in 75% of cases. CT scan and MRI of the sacroiliac joints was performed in all cases. The diagnosis was bacteriologically confirmed in 24 cases (96%). The average duration of antibiotic treatment was 83 days in the pyogenic sacroiliitis, and 102 days in brucellar sacroiliitis. The evolution was favorable in 12 patients (48%), 9 patients (36%) had sequelae of sacroiliac joint pain and 4 patients (16%) died. In our study, time frame of infectious sacroiliitis evolution did not predict the causative bacterium, hence the need for bacteriological documentation in order to prescribe appropriate antibiotic therapy.
感染性骶髂关节炎较为罕见,但可能会并发导致功能障碍的后遗症。描述突尼斯苏塞医疗中心收治的感染性骶髂关节炎患者的临床和细菌学特征。对2000年至2015年在苏塞住院的感染性骶髂关节炎患者进行回顾性描述性研究。诊断基于医学体征、影像学和微生物学指标。该研究纳入了25名患者,其中10名男性和15名女性;平均年龄为41岁(19 - 78岁)。14例(56%)骶髂关节炎由化脓性细菌引起,6例(24%)由布鲁氏菌引起,5例(20%)由结核杆菌引起。症状的平均持续时间分别为61天、45天和402天。最常见的临床体征是臀部疼痛(92%)和发热(88%)。75%的病例标准影像学评估异常。所有病例均进行了骶髂关节的CT扫描和MRI检查。24例(96%)经细菌学确诊。化脓性骶髂关节炎的抗生素治疗平均持续时间为83天,布鲁氏菌性骶髂关节炎为102天。12例患者(48%)病情好转,9例患者(36%)有骶髂关节疼痛后遗症,4例患者(16%)死亡。在我们的研究中,感染性骶髂关节炎的病程无法预测致病菌,因此需要进行细菌学记录以便开具合适的抗生素治疗。