Document Detail


Tuberculous vertebral osteomyelitis in the new millennium: still a diagnostic and therapeutic challenge.
MedLine Citation:
PMID:  15164258     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In order to determine the clinical features and current prognosis of tuberculous vertebral osteomyelitis, the charts of all patients diagnosed with definite or probable tuberculous vertebral osteomyelitis from January 1983 to June 2002 ( n=78) were reviewed. The mean delay to diagnosis was 6.1 months. Sixty-five (83.3%) patients had inflammatory spinal pain, 35 (44.9%) had some neurological deficit, and only 27 (34.6%) had fever. Paravertebral, epidural, and psoas abscesses were detected in 73.1, 65.4, and 24.4% of the cases, respectively. Culture was positive in 48% of the percutaneous biopsies and in 61.7% of the open biopsies. After histological findings were included, the diagnostic yield of percutaneous biopsies was 68%. Fifty-five (70.5%) patients required surgical treatment at some stage of the disease. Although no deaths were directly attributable to tuberculous vertebral osteomyelitis and only 5.1% of patients relapsed, the mean overall hospital stay was 69.1+/-36.9 days, and 30 (38.5%) patients had severe functional sequelae. In conclusion, diagnosis of tuberculous vertebral osteomyelitis requires a high degree of suspicion. Percutaneous biopsy should be undertaken as soon as possible in any patient with compatible symptoms or radiological images in order to initiate suitable therapy.
Authors:
J D Colmenero; M E Jiménez-Mejías; J M Reguera; J Palomino-Nicás; J D Ruiz-Mesa; J Márquez-Rivas; A Lozano; J Pachón
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2004-05-26
Journal Detail:
Title:  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology     Volume:  23     ISSN:  0934-9723     ISO Abbreviation:  Eur. J. Clin. Microbiol. Infect. Dis.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-15     Completed Date:  2004-08-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8804297     Medline TA:  Eur J Clin Microbiol Infect Dis     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  477-83     Citation Subset:  IM    
Affiliation:
Infectious Diseases Unit, Internal Medicine Department, Carlos Haya University Hospital, Avenida Carlos Haya s/n, 29010 Malaga, Spain. jdcolmenero@telefonica.net
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Antitubercular Agents / therapeutic use
Chi-Square Distribution
Cohort Studies
Combined Modality Therapy / methods
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Mycobacterium tuberculosis / isolation & purification
Orthopedic Procedures / methods
Osteomyelitis / diagnosis*,  epidemiology,  therapy*
Probability
Retrospective Studies
Risk Assessment
Severity of Illness Index
Sex Distribution
Spain / epidemiology
Spinal Diseases / diagnosis*,  epidemiology,  therapy*
Treatment Outcome
Tuberculosis, Osteoarticular / diagnosis*,  epidemiology,  therapy*
Chemical
Reg. No./Substance:
0/Antitubercular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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