Spondilodiskit olgularının retrospektif irdelenmesi
Loading...
Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Trakya Üniversitesi Tıp Fakültesi
Access Rights
info:eu-repo/semantics/openAccess
Abstract
Spondilodiskit, vertebra ve komşu disk yapılarının enfekte olmasıyla ortaya çıkan klinik tablodur. Hastalar spesifik olmayan semptomlarla başvurmakta ve tanı gecikmektedir. Çalışmamızdaki hastalar tüberküloz spondilodiskit (TS), brusella spondilodiskiti (BS) ve pyojenik spondilodiskit (PS) olmak üzere üç gruba ayrılarak farklılıkların ortaya konması amaçlandı. Trakya Üniversitesi Sağlık Uygulama ve Araştırma Merkezi Enfeksiyon Hastalıkları kliniğinde ve polikliniğinde 01 Ocak 2011 ile 01 Ocak 2021 tarihleri arasında spondilodiskit tanısıyla takip edilen, 18 yaşından büyük 109 hasta çalışmaya alındı. Çalışma retrospektif yapıldı. Çalışmadaki 109 hastanın 59’u (%54,1) PS, 33’ü (%32) BS, 17’si (%15,5) TS grubundaydı. Hastaların 65’i erkek (%59,6), 44’ü (%40,4) kadındı. Yaş ortalaması 57,6±13,8 saptandı. Yaş ortalaması BS’de düşüktü. En sık başvuru şikayeti %85,3 sıklıkla bel ağrısıydı. Gece terlemesi BS’de daha sık, kilo kaybı PS’de daha nadir saptandı. Hastaların %64’ünde en az bir kronik hastalık vardı. Brusella spondilodiskiti grubunda kronik hastalık sıklığı daha azdı. Diyabetes mellitus, PS’de daha sık saptandı. Diğer iki gruba göre lökosit ve nötrofil sayısı, nötrofil yüzdesi, C- reaktif protein ve eritrosit sedimentasyon hızı değerleri PS’de daha yüksek saptandı. Kan kültürü pozitifliği BS’de %53,6, PS’de %53,8 olarak saptandı. Üç grupta da en sık lomber tutulum saptandı. Birden fazla vertebra seviyesinin tutulumu PS’de daha nadir saptandı. Hastaların 62’sine(%56,9) tanısal ya da tedavi amaçlı cerrahi yapıldığı ve örnek alındığı saptandı. Kan ve doku kültürleri birlikte değerlendirildiğinde en sık etken S.aureus, ikinci olarak Brucella spp. saptandı. Vertebrada lokalize ağrı, ateş yüksekliği, yürümede güçlük gibi şikayetlerle başvuran hastalarda spondilodiskit ayırıcı tanıda mutlaka düşünülmelidir. Erken tanı ve uygun tedavi spondilodiskitte mortalite ve morbiditeyi azaltmaktadır. Öykü, laboratuar ve radyolojik bulgular, kan kültürü, serolojik tetkikler etken mikroorganizmayı tahmin etmede yol gösterici olabilmektedir. İnvaziv girişimlerle alınan doku örneklerinin mikrobiyolojik ve histopatolojik incelenmesi kesin tanıda önemlidir. Fakat invaziv girişimlere rağmen bazı hastalarda etken saptanamayabilir.
Spondylodiscitis is the infection of the vertebra and adjacent disc structures. Spondylodiscitis patients present with nonspecific symptoms and therofore diagnosis is delayed. The patients in our study were divided into three groups as tuberculous spondylodiscitis (TS), brucella spondylodiscitis (BS) and pyogenic spondylodiscitis (PS). It was aimed to reveal differences between groups. 109 patients older than 18 years of age who were followed up with the diagnosis of spondylodiscitis in the Trakya University Health Practice and Research Center Infectious Diseases clinic and polyclinic between January 01, 2011 and January 01, 2021 were included in the study. The study was done retrospectively. Of 109 patients in the study, 59 (54.1%) were in the PS group, 33 (32%) were in the BS group, and 17 (15.5%) were in the TS group. Of all the patients, 65 (59.6%) were male and 44 (40.4%) were female. The mean age was 57.6±13.8 years. The mean age was lower in BS. The most common complaint was low back pain reported in 85.3% of patients. Night sweats were more common in BS, and weight loss was less common in PS. 64% of the patients had at least one chronic disease. The incidence of chronic disease was less in the Brucella spondylodiscitis group. Diabetes mellitus was detected more frequently in PS. Compared to the other two groups; leukocyte and neutrophil counts, neutrophil percentage, C-reactive protein and erythrocyte sedimentation values were found to be higher in PS. Blood culture positivity was found to be 53.6% in BS and 53.8% in PS. Lumbar involvement was the most common finding in all three groups. Involvement of more than one vertebral level was less common in PS. Diagnostic/therapeutic surgery was performed and samples were obtained for 62 (56.9%) of the patients. When tissue and blood cultures were evaluated together, the most common agent was S aureus. Brucella spp was the second most common agent. Spondylodiscitis should be considered in the differential diagnosis of patients presenting with localized spinal pain, fever, and difficulty in walking. Early diagnosis and appropriate treatment reduce mortality and morbidity in spondylodiscitis. History of present illness, laboratory values, radiological findings, blood cultures, serological examinations can be helpful in identifying the causative microorganism. Microbiological and histopathological examination of samples obtained by invasive procedures is important in definitive diagnosis. However, despite invasive procedures, the causative microorganism may not be detected in some patients.
Spondylodiscitis is the infection of the vertebra and adjacent disc structures. Spondylodiscitis patients present with nonspecific symptoms and therofore diagnosis is delayed. The patients in our study were divided into three groups as tuberculous spondylodiscitis (TS), brucella spondylodiscitis (BS) and pyogenic spondylodiscitis (PS). It was aimed to reveal differences between groups. 109 patients older than 18 years of age who were followed up with the diagnosis of spondylodiscitis in the Trakya University Health Practice and Research Center Infectious Diseases clinic and polyclinic between January 01, 2011 and January 01, 2021 were included in the study. The study was done retrospectively. Of 109 patients in the study, 59 (54.1%) were in the PS group, 33 (32%) were in the BS group, and 17 (15.5%) were in the TS group. Of all the patients, 65 (59.6%) were male and 44 (40.4%) were female. The mean age was 57.6±13.8 years. The mean age was lower in BS. The most common complaint was low back pain reported in 85.3% of patients. Night sweats were more common in BS, and weight loss was less common in PS. 64% of the patients had at least one chronic disease. The incidence of chronic disease was less in the Brucella spondylodiscitis group. Diabetes mellitus was detected more frequently in PS. Compared to the other two groups; leukocyte and neutrophil counts, neutrophil percentage, C-reactive protein and erythrocyte sedimentation values were found to be higher in PS. Blood culture positivity was found to be 53.6% in BS and 53.8% in PS. Lumbar involvement was the most common finding in all three groups. Involvement of more than one vertebral level was less common in PS. Diagnostic/therapeutic surgery was performed and samples were obtained for 62 (56.9%) of the patients. When tissue and blood cultures were evaluated together, the most common agent was S aureus. Brucella spp was the second most common agent. Spondylodiscitis should be considered in the differential diagnosis of patients presenting with localized spinal pain, fever, and difficulty in walking. Early diagnosis and appropriate treatment reduce mortality and morbidity in spondylodiscitis. History of present illness, laboratory values, radiological findings, blood cultures, serological examinations can be helpful in identifying the causative microorganism. Microbiological and histopathological examination of samples obtained by invasive procedures is important in definitive diagnosis. However, despite invasive procedures, the causative microorganism may not be detected in some patients.
Description
Keywords
Tüberküloz spondilodiskit, Brusella spondilodiskiti, Pyojenik spondilodiskit, Spinal enfeksiyonlar, Tuberculous spondylodiscitis, Brucella spondylodiscitis, Pyogenic spondylodiscitis, Spinal infections
