| Tuberculous vertebral osteomyelitis in the new millennium: still a diagnostic and therapeutic challenge. | |
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MedLine Citation:
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PMID: 15164258 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Journal Article Date: 2004-05-26 |
Journal Detail:
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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:
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Created Date: 2004-06-15 Completed Date: 2004-08-17 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8804297 Medline TA: Eur J Clin Microbiol Infect Dis Country: Germany |
Other Details:
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Languages: eng Pagination: 477-83 Citation Subset: IM |
Affiliation:
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Infectious Diseases Unit, Internal Medicine Department, Carlos Haya University Hospital, Avenida Carlos Haya s/n, 29010 Malaga, Spain. jdcolmenero@telefonica.net |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Antitubercular Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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