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THU0251 Brucellar and Tuberculosis Spondylodiscitis: Report of 21 Cases
  1. M. Jguirim1,
  2. L. Mani1,
  3. A. Mhenni1,
  4. S. Zrour1,
  5. M. Younes2,
  6. I. Béjia1,
  7. M. Touzi1,
  8. N. Bergaoui1
  1. 1Rheumatology Service, Hospital Fattouma Bourguiba, Monastir
  2. 2Rheumatology Service, Hospital Taher Sfar, Mahdia, Tunisia

Abstract

Background Spinal infections can be described etiologically as pyogenic, granulomatous (tuberculous, brucellar, fungal) and parasitic.

Objectives Our aim was to analyze clinical, laboratory and radiological features of spontaneous spondylodiscitis secondary to tuberculosis and brucellosis.

Methods A retrospective study which included 21 patients diagnosed as spondylodiscitis, between 1991 and 2013. Of these patients, 17 (81%) have tuberculosis spondylodiscitis (TS) and 4 (19%) have brucellar spondylodiscitis (BS).

Results Six patients (28.5%) were male and 15 (71.5%) were female (sex ratio F/M: 2.5). The mean age of the patients was 45 years. History of tuberculosis was found in three cases, a high fever was present in only nine cases, six patients have diabetes and history of previous surgery was found in one case.

The locations observed: lumbar in 14 cases, dorsal in 4 cases, cervical in two cases and sacred in one case. Elevated ESR was present in 11 cases. According to the radiological imaging studies, paravertebral abscess, psoas and epidural abscesses were found respectively in nine, four and nine cases as complication of spondylodiscitis.

A percutaneous biopsy computed tomography-guided was practiced in 17 cases, was successful in six cases. The diagnosis was based on microbiological results in 7 cases and on histological results in only five cases. All patients received appropriate antibiotic treatment.

Conclusions Tuberculosis remains the commonest cause of spinal infection in Tunisia. A high index of suspicion is needed for prompt diagnosis to ensure improved long-term outcomes. An early diagnosis is essential to enable appropriate choice of therapeutic agents, even in the absence of microbiologic confirmation.

References

  1. Yasar K, Pehlivanoglu F, Cicek G, Sengoz G. The evaluation of the clinical, laboratory and the radiological findings of the fifty-five cases diagnosed with tuberculous, Brucellar and pyogenic spondylodiscitis. J Neurosci Rural Pract. 2012;3:17-20.

  2. Celik AK, Aypak A, Aypak C. Comparative analysis of tuberculous and brucellar spondylodiscitis. Trop Doct. 2011;41:172-4

Disclosure of Interest None declared

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