Browse

A Comparative Study of Pyogenic and Tuberculous Spondylodiscitis

Cited 62 time in Web of Science Cited 66 time in Scopus
Authors

Kim, Chung-Jong; Song, Kyoung-Ho; Jeon, Jae-Hyun; Park, Wan Beom; Kim, Hong-Bin; Choe, Kang Won; Kim, Nam Joong; Oh, Myoung-don; Park, Sang Won

Issue Date
2010-10-01
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
SPINE; Vol.35 21; E1096-E1100
Keywords
spondylitisdiscitispyogenictuberculosis
Abstract
Study Design. We performed a retrospective review of 126 cases of infectious spondylodiscitis over a 4-year period. Objective. Differentiation between pyogenic spondylodiscitis (PS) and tuberculous spondylodiscitis (TS) is essential for deciding on the appropriate therapeutic regimen. The aim of this study was to compare the characteristics of the 2 forms of spondylodiscitis. Summary of Background Data. There has been much effort to distinguish the radiologic findings in PS versus TS, but classification based on radiologic findings alone had limitations yet. Methods. We compared the predisposing factors or associated illnesses, clinical, radiologic, and laboratory features of microbiologically confirmed cases of PS and TS in 2 university hospitals. Results. Of 126 patients, 79 had PS and 47 TS. PS was more frequently associated with the followings: previous invasive spinal procedures (PS vs. TS: 32.9% vs. 8.5%), preceding bacteremia (13.9% vs. 0%), chronic renal failure (12.7% vs. 0%), liver cirrhosis (13.9% vs. 0%), fever (temperature >38 degrees C) (48.1% vs. 17.0%), white blood cell counts over 10,000/mm(3) (41.8% vs. 19.1%), fraction of neutrophils >75% (49.4% vs. 27.7%), C-reactive protein levels over 5 mg/dL (58.2% vs. 27.7%), erythrocyte sedimentation rate levels over 40 mm/h (84.4% vs. 66.0%), and ALP levels over 120 IU/L (45.6% vs. 17.0%). TS was frequently associated with active tuberculosis of other organs (0% vs. 31.9%), longer diagnostic delay (47.6 vs. 106.3 days), involvement of thoracic spines (21.5% vs. 38.3%), and involvement of >= 3 spinal levels (11.4% vs. 36.2%). Conclusion. Previous invasive spinal procedures, preceding bacteremia, fever, higher white blood cell counts, C-reactive protein, ALP, and higher fraction of neutrophils are suggestive of PS. Concurrent active tuberculosis, more indolent course and involvement of thoracic spines are suggestive of TS. When the causative organism is not identified despite all efforts at diagnosis, combination of the clinical, radiologic, and laboratory characteristics of the patient is helpful.
ISSN
0362-2436
Language
English
URI
https://hdl.handle.net/10371/77681
DOI
https://doi.org/10.1097/BRS.0b013e3181e04dd3
Files in This Item:
There are no files associated with this item.
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
  • mendeley

Items in S-Space are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse