Document Detail

Tuberculous spondylitis: risk factors and clinical/paraclinical aspects in the south west of Iran.
MedLine Citation:
PMID:  21126725     Owner:  NLM     Status:  In-Process    
BACKGROUND AND OBJECTIVES: Tuberculous spondylitis (TS) is both the most common and the most dangerous form of TB infection. Delay in diagnosis and management causes spinal cord compression and spinal deformity. The aim of this study was to identify the clinical and paraclinical aspects and also to describe its risk factors in Khuzestan, a province located in the south west of Iran.
METHOD: In this medical record-based retrospective study 69 cases of TS registered in Khuzestan Health Center from 1999 to 2008, were reviewed. For each TS case two extra pulmonary TB cases (without spinal involvement) were randomly selected as control. Related data in patients were analyzed in SPSS software (version 16, USA) using chi square and Fishers exact test. Differences with P<0.05 were considered significant.
RESULTS: The mean age of patients was 43.7±18.3 years, and 60.8% were males. The mean time of delay: for patients' delay, doctors' delays and from diagnosis to initiation of treatment was 1.8±1.1, 6.8±4.3 and 1.3±1.2 months, respectively. In 56 cases (81.1%), TS was diagnosed on lumbosacral radiograph, in remaining cases by lumbosacral MRI. Twenty patients (30.4%) had a previous TB history, 30.4% had underlying medical disorders such as diabetes mellitus (30%), steroid use (45%), chronic renal failure (50%). The most common clinical findings were: backache 98.5%, fever 26.1%, spinal tenderness 84.1%, paraparesis 26.1%, and kyphosis 28.9%. Laboratory results were: elevated sedimentation rate (ESR) 92.8% and positive CRP 86.9%. There were statistically significant differences in age, gender, CRF, imprisonment and previous TB infection between the two groups.
CONCLUSION: TS is therefore a diagnosis that attending doctors need to consider early. Patients in endemic area of TB, presenting with back pain in association with constitutional symptoms and elevated ESR and or positive CRP should be investigated to exclude TS. Older age, male gender, chronic peritoneal dialysis, imprisonment and previous TB infection may be the main risk factors of TS.
S M Alavi; M Sharifi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-11-10
Journal Detail:
Title:  Journal of infection and public health     Volume:  3     ISSN:  1876-035X     ISO Abbreviation:  J Infect Public Health     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101487384     Medline TA:  J Infect Public Health     Country:  England    
Other Details:
Languages:  eng     Pagination:  196-200     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.
Infectious Disease Ward, Jundishapur Infectious and Tropical Diseases Research Center, Razi Hospital of Jundishapur University of Medical Sciences, No. 52, West 11 Avenue, Kianabad, Ahvaz, Iran.
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