Rheumatology Medical News about pypgenic vertebral osteomyelitis;clinical characteristics

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Pyogenic vertebral osteomyelitis: A systematic review of clinical characteristics
Seminars in Arthritis and Rheumatism, 04/16/09

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

A systematic review of the clinical characteristics of PVO
The inclusion criteria: studies with ≥10 subjects diagnosed with PVO based on the combination of clinical presentation with either:
- a definitive bacteriologic diagnosis
- or pathological and/or imaging studies

Results

14 studies; 1008 patients with PVO
62% were men, with back pain and fever as the most common presenting symptoms
Diabetes mellitus was the most common underlying medical illness
Urinary tract was the commonest source of infection
Staphylococcus aureus was the 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, revealing lumbar as the most commonly affected area
The attributable mortality was 6%; relapses and neurological deficits in the 32% and 32% of the cases, respectively

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