Publication: Vertebral osteomyelitis: clinical features and diagnosis
Program
KU-Authors
KU Authors
Co-Authors
Gök, Şebnem Eren
Kaptanoğlu, Erkan
Çelikbaş, Aysel Kocagül
Baykam, Nurcam
Eroğlu, Mustafa
Dokuzoğuz, Başak
Advisor
Publication Date
2014
Language
English
Type
Journal Article
Journal Title
Journal ISSN
Volume Title
Abstract
We aimed to describe clinical and diagnostic features of vertebral osteomyelitis for differential diagnosis and treatment. This is a prospective observational study performed between 2002 and 2012 in Ankara Numune Education and Research Hospital in Ankara, Turkey. All the patients with vertebral osteomyelitis were followed for from 6months to 3years. In total, 214 patients were included in the study, 113 out of 214 (53%) were female. Out of 214 patients, 96 (45%) had brucellar vertebral osteomyelitis (BVO), 63 (29%) had tuberculous vertebral osteomyelitis (TVO), and 55 (26%) had pyogenic vertebral osteomyelitis (PVO). Mean number of days between onset of symptoms and establishment of diagnosis was greater with the patients with TVO (266days) than BVO (115days) or PVO (151days, p<0.001). In blood cultures, Brucella spp. were isolated from 35 of 96 BVO patients (35%). Among 55 PVO patients, the aetiological agent was isolated in 11 (20%) patients. For tuberculin skin test >15mm, sensitivity was 0.66, specificity was 0.97, positive predictive value was 0.89, negative predictive value was 0.88, and receiver operating characteristics area was 0.8. Tuberculous and brucellar vertebral osteomyelitis remained the leading causes of vertebral osteomyelitis with delayed diagnosis. In differential diagnosis of vertebral osteomyelitis, consumption of unpasteurized cheese, dealing with husbandry, sweating, arthralgia, hepatomegaly, elevated alanine transaminase, and lumbar involvement in magnetic resonance imaging were found to be predictors of BVO, thoracic involvement in magnetic resonance imaging and tuberculin skin test >15mm were found to be predictors of TVO, and history of spinal surgery and leucocytosis were found to be predictors of PVO.
Description
Source:
Clinical Microbiology and Infection
Publisher:
Elsevier Sci Ltd
Keywords:
Subject
Infectious diseases, Microbiology