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논문 기본 정보

자료유형
학술저널
저자정보
저널정보
대한감염학회 Infection and Chemotherapy Infection and Chemotherapy 제43권 제1호
발행연도
2011.1
수록면
48 - 54 (7page)

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Background: Infectious spondylitis (IS) is a rare infectious disorder, which is often associated with significant neurologic deficits and mortality. However, previous domestic studies, have paid more attention to the differential diagnosis between pyogenic spondylitis (PS) and tuberculous spondylitis (TS) rather than to the treatment and outcomes of them. The aims of this study were to determine the clinical manifestations and outcomes of IS and to determine its prognostic factors. Materials and Methods: We compared the predisposing factors or associated illnesses and the clinical, radiological and laboratory features of the microbiologically confirmed cases of PS and TS in a tertiary hospital from January 2004to December 2009. We also analyzed the treatment outcomes and prognostic factors. Results: Of the 116 patients (78 males and 38 females), 93 (39 definite and 54 possible cases) had PS and 23 patients had TS. The patients with PS had a significantly higher rate of fever and higher levels of a WBC, CRP and ESR at the initial presentation than did the TS patients (P<0.05). TS was frequently associated with active tuberculosis of other organs and involvement of thoracic vertebral lesions. Among the 116 cases, 104 cases (83 PS cases, 21 TS cases) had followedup. The mean duration of intravenous antibiotics treatment was 6.3 weeks (range:0.8-16.0) for the PS patients, and the mean duration of anti-tuberculosis treatment was 36.0 weeks (range: 1.3-81.4 weeks) in the TS patients The proportion of favorable outcomes (complete recovery) was 34% and the proportion of poor ones was 66% (partial recovery with sequelae [60%] and death [6%]). The poor outcome of IS were independently associated with an age >65 years (OR=3.88,95% CI=1.28-11.71, P=0.016) and an initial presentation of neurologic deficits (OR=8.69, 95% CI= 2.86-26.39, P<0.001). Conclusions: The prognosis of the patients with IS was poor with partial recovery and sequelae in 60% of the patients and the mortality was 6%. The optimal treatment consisting of antibiotics and surgical treatment was needed to prevent poor outcomes of IS, and especially for the patients with an age >65 years and who displayed neurologic deficits at the initial presentation.
#Spondylitis #Pyogenic #Tuberculous #Prognosis

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참고문헌 (28)

참고문헌 신청
Buchelt M / 1993 / Comparison of tuberculous and pyogenic spondylitis. An analysis of 122 cases / Clin Orthop Relat Res 296 : 192 ~ 199 google schola Butler JS / 2006 / Nontuberculous pyogenic spinal infection in adults: a 12-year experience from a tertiary referral center / Spine 31 : 2695 ~ 2700 google schola Chang MC / 2006 / Tuberculous spondylitis and pyogenic spondylitis: comparative magnetic resonance imaging features / Spine 31 : 782 ~ 788 google schola Colmenero JD / 1997 / Pyogenic, tuberculous, and brucellar vertebral osteomyelitis: a descriptive and comparative study of 219 cases / Ann Rheum Dis 56 : 709 ~ 715 google schola Cottle L / 2008 / Infectious spondylodiscitis / J Infect 56 : 401 ~ 412 google schola

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