科研之友
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摘要
objective: to study the clinical-epidemiological characteristics of infectious spondylodiscitis (is) in adults of our health area in the late 20 years. material and methods: we performed a retrospective analysis of the medical records of adult patients with a diagnosis of both, tuberculous (ts) and non tuberculous spondylodiscitis (nts), between january 1983 and december 2003. the diagnosis was made when compatible clinical-radiological picture were present in association with at least two positive blood cultures and / or micro-organism recovery from vertebral samples. additionally, ts was diagnosed when biopsy showed typical caseating granulomas from vertebral or extra-vertebral lesions. results: 17 ts and 22 nts were identified. the mean age was lower in patients with ts than in nts (43.5 ㊣ 24.6 vs 52.0 ㊣ 15.2 years; mean ㊣ sd). patients were predominately males in both, ts (57%) and nts (82%; p %26lt; 0001). the time between the onset of symptoms and diagnosis was longer in ts (16,4 ㊣ 15,2 weeks) than in nts (3.9 ㊣ 3.2 weeks), p= 0.005. seven (41%) of the 17 patients with ts had active extra-vertebral tuberculosis. a source of infection was presumed in 20 nts (90%), mainly surgical spinal procedures (9/22.41%). in three ts and four nts one o more predisposing factors were observed. the patients with nts presented a higher prevalence of fever (41% vs 24%; p= 0.0003) and leucocytosis (41% vs 12%; p%26lt; 0.001), but less neurological impairment (9% vs 21% p= 0,01). none patient with nts presented mixed infection and staphylococcus aureus was the main pathogen (14/22.64%) follows by streptococcus sp (6/22.27%). klebsiella pneumoniae and proteus mirabilis were the remain causative agents. spinal cord decompression and surgical drainage of abscess were performed in five patients (24%) with ts and four patients with nts (18%), p= 0.0027). neurological sequels were more common in the patients with ts (24% vs 14%, p= 0.008). the global incidence of is was 2.2 cases / 105 inhabitan
