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See Latest ArticlesPyogenic vertebral osteomyelitis: A systematic review of clinical characteristics
Seminars in Arthritis and Rheumatism, 07/27/09
Mylona E et al. – Pyogenic vertebral osteomyelitis (PVO) is a cause of back pain that can lead to neurologic deficits in 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 review of the clinical characteristics of PVO
- Inclusion criteria: studies with ≥10 subjects diagnosed with PVO based on combination of clinical presentation with either a definitive bacteriologic diagnosis or pathological and/or imaging studies
- 14 studies met selection criteria; 1008 pts 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 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 cases
- Bone scanning and CT or MRI were positive in 94% of cases, revealing lumbar as the most commonly affected area
- Attributable mortality was 6%, while relapses and neurological deficits were described in 32% and 32% of cases, respectively
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