Zanon Igor de Barcellos, Meves Robert, Klautau Giselle Burlamaqui
Grupo de Afecções da Coluna Vertebral, Departamento de Ortopedia e Traumatologia, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil.
Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2023 Mar 24;58(1):92-100. doi: 10.1055/s-0042-1756638. eCollection 2023 Feb.
To describe the clinico-epidemiological, laboratory, and radiological characteristics of tuberculous spondylodiscitis in the Brazilian population, and to assess whether there are differences between patients in whom the etiological agent in Pott disease was isolated or not. Patients diagnosed with tuberculosis (TB) of the spine (Pott disease) underwent follow-up between 2009 and 2019 at a quaternary hospital and were divided into 2 groups: successful isolation (SI) of the etiological agent (through bacilloscopy, culture, or positive molecular rapid test) and unsuccessful isolation (UI) of the etiological agent. From a total of 26 patients diagnosed with TB of the spine, 21 (80.7%) were male, with a mean age of 40 ± 22.5 years. The average lymphocyte counts were higher in the UI group (25.35 ± 13.08; = 0.025) compared to the SI group (14.18 ± 7.48). Moreover, the monocyte/lymphocyte ratio was lower in the UI group (0.39 ± 0.22; = 0.009) than in the SI group (0.89 ± 0.65). Relative lymphocyte counts higher than or equal to 16.7 had a sensitivity of 76.9% and specificity of 62.5% in the UI group. Values higher than or equal to 0.58 for the monocyte/lymphocyte ratio showed a sensitivity of 84.6% and specificity of 75.0% in the UI group. No differences were observed regarding the clinico-epidemiological and radiological characteristics of the two experimental groups. However, the UI group had higher lymphocyte counts and a lower monocyte/lymphocyte ratio.
描述巴西人群中结核性脊椎椎间盘炎的临床流行病学、实验室及影像学特征，并评估在波特病中病原体是否被分离出的患者之间是否存在差异。脊柱结核（波特病）确诊患者于2009年至2019年在一家四级医院接受随访，并被分为两组：病原体成功分离组（SI，通过细菌镜检查、培养或分子快速检测呈阳性）和病原体未成功分离组（UI）。在总共26例脊柱结核确诊患者中，21例（80.7%）为男性，平均年龄为40±22.5岁。与SI组（14.18±7.48）相比，UI组的平均淋巴细胞计数更高（25.35±13.08；P = 0.025）。此外，UI组的单核细胞/淋巴细胞比值（0.39±0.22；P = 0.009）低于SI组（0.89±0.65）。在UI组中，相对淋巴细胞计数高于或等于16.7时，敏感性为76.9%，特异性为62.5%。单核细胞/淋巴细胞比值高于或等于0.58时，在UI组中的敏感性为84.6%，特异性为75.0%。两个试验组在临床流行病学和影像学特征方面未观察到差异。然而，UI组的淋巴细胞计数更高，单核细胞/淋巴细胞比值更低。
