[Spondylodiscitis. Analysis of 25 cases].
BACKGROUND
Spondylodiscitis is a rare but prolonged inflammation of two adjacent vertebral bodies and the disk in between.


OBJECTIVE
To report the clinical features of a series of patients with spondylodiscitis.


METHODS
A retrospective analysis of medical records of patients with spondylitis, identified between 1989 and 2002.


RESULTS
A total of 25 cases were identified, 15 female, aged 49.8 years as a mean. Their mean evolution before admission was 4.3 months. Main complaints were back or radicular pain. Mild anemia was present in most patients. Mean erythrocyte sedimentation rate and C reactive protein values were 66 mm/h and 60 mg/L, respectively. Forty four percent of patients had neurological complications. Vertebral computed tomography and scintigraphic studies were done in 72% of patients, but magnetic resonance imaging was done only in 4 (16%). In 18 patients, a tissue sample for pathological and microbiological analysis, was obtained by imaging guiding or surgically. Tuberculosis, diagnosed on pathology, was the leading cause of spondylitis in nine cases (36%), followed by Staphylococcus aureus infection in five (20%). Other agents found were E coli and group D Streptococcus (one each). Age, symptoms, evolution time and different laboratory parameters did not differ between patients with tuberculosis and patients with other causes. A microbiological cause was not established in 36% of cases. Most patients evolved satisfactorily and recovered from neurological complications (88%). One patient with tuberculosis did not improve after prolonged treatment and 2 patients infected with S aureus died (8%).


CONCLUSIONS
Spondylodiscitis is associated to a diversity of microbial agents and in most cases has a favorable prognosis.
Fica
Alberto
A
Sección de Infectología, Departamento de Medicina y Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Av. Santos Dumont 999, Independencia, Santiago. afica@ns.hospital.uchile.cl
Bozán
Francisca
F
Aristegui
Magdalena
M
Bustos
Patricio
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D001799:Blood Sedimentation; D015299:Discitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000382:microbiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000150:complications; D014057:Tomography, X-Ray Computed; D014399:Tuberculosis, Spinal / Q000150:complications