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AB0932 Infectious Spondylodiscitis – a Case Series Analysis
  1. A. Aouadi,
  2. D. Kaffel,
  3. I. Cherif,
  4. W. Hamdi,
  5. I. Zouch,
  6. M.M. Kchir
  1. Rheumatology, Kassab Institute, Manouba, Tunisia

Abstract

Background Spondylodiscitis is a quite rare disease characterized by insidious onset and non-specific symptoms such as back pain and fever. Consequently, early diagnosis is difficult and is often missed despite repeated warnings in the medical journals and better access to imaging techniques such as magnetic resonance imaging (MRI). Spondylodiscitis may take acute, subacute or chronic course.

Objectives We aimed to describe the clinical and laboratory features as well as diagnostic difficulties in the case series of spondylodiscitis.

Methods Retrospective study including patients diagnosed as spondylodiscitis and hospitalized in our department between 2006 and 2014.

Results Sixteen patients were included. Ten patients (62,5%) were male. The mean age of our patients was 57 years [20 – 83]. Predisposing factors were found in 7 patients (43%): diabetes in 5 cases, chronic renal failure in 1 case and a patient with sickle cell disease. The lumbar spine was most affected (75%), the dorsal spine was affected in (12,5%) as the cervical spine (12,5%). A-multi stage spondylodiscitis was found in 3 cases. A neurological deficit was noted in 2 patients. Inflammation tests were disturbed in 87,5% of them. Radiographs of the spine were abnormal in all cases. Fourteen patients had MRI exam, showed epiduritis in 6 patients and paravertebral abscess in 7 patients. The causative microorganism was identified in 14 cases (87,5%): brucella in 6 patients, mycobacterium tuberculosis in 5 patients, staphylococcus in 1 case, Gram-negative germs in 1 case and streptococcus in 1 case. Multi-bacterial spondylodiscitis was found in 1 patient. All of them received initially adapted antibiotics. Two patients have not been followed, and most of the rest showed good response (78%). Neurological complication occurred in 1 case and sepsis occurred in 1 other case. Disturbance of liver function due to treatment occurred in two cases with good subsequent evolution.

Conclusions Spondylodiscitis is an emergency which must be diagnosed on time to avoid life threatening complications, neurological sequelae and spinal deformities.

Disclosure of Interest None declared

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