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Pyogenic vertebral osteomyelitis: A systematic review of clinical characteristics
Seminars in Arthritis and Rheumatism, 09/19/08

Mylona E et al. - Pyogenic vertebral osteomyelitis (PVO) is an illness of middle-aged individuals with underlying medical illnesses. Although the mortality rate is low, relapses and neurological deficits are common, making early diagnosis a major challenge for the physician.

Methods

Aim was to systematically review the clinical characteristics of PVO
Inclusion criteria - studies with ≥10 subjects diagnosed for PVO with either a bacteriologic diagnosis or pathological and/or imaging studies

Results

14 studies met selection criteria; included 1008 pts with PVO
Of them, 62% were men, with back pain and fever as the most common presenting symptoms
Diabetes mellitus - most common underlying medical illness
Urinary tract - most commonest source of infection
Staphylococcus aureus - most commonly isolated organism
CT guided or open biopsy yielded the causative organism more often than blood cultures
Plain radiography showed abnormalities in 89% of the cases
Bone scanning and CT or MRI were positive in 94% of the cases; lumbar most commonly affected area
The attributable mortality was 6%, while relapses and neurological deficits were described in the 32% cases