Pyogenic Vertebral Osteomyelitis: A Review of 14 Cases
| Autor: | Aziz Nather, Hwan T. Hee, Vikram David, Joseph Thambiah |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Pyogenic vertebral osteomyelitis medicine.disease_cause Posterior approach 03 medical and health sciences Postoperative Complications 0302 clinical medicine lcsh:Orthopedic surgery Diabetes mellitus medicine Humans Aged Retrospective Studies 030222 orthopedics business.industry Osteomyelitis 030229 sport sciences Middle Aged medicine.disease Anti-Bacterial Agents Surgery lcsh:RD701-811 Streptococcus agalactiae Staphylococcus aureus Female Spinal Diseases Lumbar spine Presentation (obstetrics) business |
| Zdroj: | Journal of Orthopaedic Surgery, Vol 13 (2005) |
| ISSN: | 2309-4990 |
| DOI: | 10.1177/230949900501300305 |
| Popis: | Purpose.To review and evaluate the management of 14 patients with pyogenic vertebral osteomyelitis at National University Hospital, Singapore between 1998 and 2001.Methods.Demographic pattern, predisposing factors, clinical presentation, co-morbidities, microbiology, treatment, and complications of 14 patients were retrospectively reviewed.Results.The mean age at presentation was 62.5 years and the male to female ratio was 6:1. The mean follow-up duration was 12.5 months. The most common predisposing condition was diabetes mellitus (n=5). The most common site of infection was the lumbar spine (n=8), followed by the thoracic (n=4) and cervical (n=2) spine. Staphylococcus aureus was the most common causative organism isolated (n=9), followed by methicillin-resistant S aureus (n=3), Pseudomonas pseudomallei (n=1), and Streptococcus agalactiae (n=1). 12 patients were treated surgically: 8 by an anterior approach, 3 by a posterior approach, and one by a combination of the 2. The mean period of antibiotic use was 11.4 weeks. One patient with melioidosis involving the T9 to T11 vertebrae caused by P pseudomallei died of empyema and septicaemia 22 months after presentation.Conclusion.Pyogenic vertebral osteomyelitis is not uncommon in the elderly, especially those with predisposing conditions such as diabetes mellitus. Computed tomography–guided needle biopsy is recommended to investigate causative micro-organisms. Aggressive surgical debridement and prolonged antibiotic therapy were necessary in patients with methicillin-resistant S aureus, P pseudomallei, and S agalactiae. |
| Databáze: | OpenAIRE |
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