| Autor: |
T. Riaz, M. Howard, F. Diehn, A. J. Tande, C. Ross, P. Huddleston, E. Berbari |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
|
| Zdroj: |
Journal of Bone and Joint Infection, Vol 7, Pp 213-219 (2022) |
| Druh dokumentu: |
article |
| ISSN: |
2206-3552 |
| DOI: |
10.5194/jbji-7-213-2022 |
| Popis: |
Background: Aspiration of intervertebral disc space is often done to confirm the diagnosis of native vertebral osteomyelitis. A study has not been done examining the utility of cell counts and differentials of the aspirated fluid in diagnosing native vertebral osteomyelitis (NVO). Methods: In this feasibility study, we prospectively enrolled patients with a suspected diagnosis of NVO referred to the Division of Neuroradiology for image-guided needle aspiration of the intervertebral disc. In this study, manual cell count was done on the aspirated fluid, followed by a differential cytospin technique and touch prep. We obtained demographic, lab, and microbiologic data and used the receiver operating curve (ROC) for statistical analysis. Results: Over 12 months, we performed 17 aspirates on 14 patients. The median age was 70.5 years (range: 45–77). The median manual cell count on the aspirated fluid was 52 cells µL−1 (range: 0–6656), the median neutrophil percentage on the touch prep slide was 73 % (range: 5 %–100 %), and the median neutrophil percentage on the cytospin slide was 82 % (range: 0 %–100 %). Routine bacterial cultures were positive in five cases, and the 16S ribosomal RNA gene polymerase chain reaction was positive in two cases. The optimal cutoff for a cell count of 104 total nucleated cells offered a sensitivity and specificity of 86 %, and a neutrophil cutoff of 83 % was associated with a 71 % sensitivity and specificity. Conclusion: An image-guided aspirated specimen leukocyte differential of ≥83 % neutrophils or a leukocyte count of ≥104 µL−1 was a sensitive and specific test for diagnosing patients with suspected NVO. Additionally, more extensive studies are warranted to confirm the findings. |
| Databáze: |
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