Pyogenic and tuberculous spondylodiskitis (vertebral osteomyelitis) in 80 adult patients.
Bacterial spondylodiskitis--i.e., adjacent vertebral osteomyelitis and diskitis--was studied in 80 adult patients. The infection was due to Mycobacterium tuberculosis in 31 cases (39%) and to pyogenic bacteria in 49 cases (61%). The latter pathogens included gram-negative bacilli in 16 cases (20%), Staphylococcus species in 15 (19%), Streptococcus species in 9 (11%), and Corynebacterium species in 1 (1%); the pathogens in the 8 remaining cases (10%) were not identified. Of the patients with tuberculous spondylodiskitis, 55% came from countries where tuberculosis is endemic (P < .001). Cases due to staphylococci and those due to M. tuberculosis were associated with a high frequency of previous active infection with those respective organisms at any site (47% and 42%, respectively; P < .001) and with a high rate of neurological complications (33% and 32%, respectively; P < .001). Nine patients with pyogenic spondylodiskitis (18%) but only one patient with tuberculous spondylodiskitis (3%) had diabetes mellitus (P < .05). Blood cultures were positive in 23 (56%) of the 41 cases of pyogenic spondylodiskitis due to an identified bacterium. Discovertebral needle biopsy contributed to the bacteriologic diagnosis in 29 (74%) of 39 cases.
Perronne
C
C
Department of Infectious and Tropical Diseases, Hôpital Bichat-Claude Bernard, Paris, France.
Saba
J
J
Behloul
Z
Z
Salmon-Céron
D
D
Leport
C
C
Vildé
J L
JL
Kahn
M F
MF
D000328:Adult; D000368:Aged; D001431:Bacteriological Techniques; D001707:Biopsy, Needle; D015299:Discitis / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis; D006801:Humans; D007403:Intervertebral Disc / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis; D013290:Streptococcal Infections / Q000175:diagnosis; D014399:Tuberculosis, Spinal / Q000175:diagnosis / Q000473:pathology