Clinical findings of vertebral osteomyelitis: Brucella spp. versus other etiologic agents

Rheumatol Int. 2012 Nov;32(11):3449-53. doi: 10.1007/s00296-011-2213-3. Epub 2011 Nov 6.

Abstract

We aimed to evaluate patients with vertebral osteomyelitis (VO) in our region and to compare the clinical and laboratory parameters of brucellar and non-brucellar VO patients (NBVO). This retrospective study included 80 patients with VO followed in our hospital between August 2004 and September 2010. The distribution of gender was 43 females (53.8%) and 37 males (46.2%) with average age of 52.5. Patients with brucellar vertebral VO (BVO; n = 30) accounted for 37.5% of all patients, and the rest (n = 50) were with NBVO. Co-morbidities existed in 32.5% of patients. In statistical comparison of VO patients who had the Brucella spp. as the infectious agent with patients of VO by non-brucellar pathogens, the following factors were found out to be significantly associated with BVO; low Charlson score (P = 0.0001), lower co-incidence with chronic renal failure (P = 0.001), high frequency of constitutional symptoms (P = 0.006), fever (P = 0.005), low-level inflammatory markers (WBC; Neutrophil; ESR; CRP, P values 0.006; 0.001; 0.022; 0.002, respectively), low-rate surgical treatment (P = 0.02) and culture positivity (P = 0.0001) and higher hemoglobin, total protein, albumin values (P = 0.002; 0.032; 0.016, respectively). VO may be strongly associated with brucellosis in patients presenting with fever and symptoms, low Charlson score and indistinct inflammatory markers.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Brucella / isolation & purification*
  • Brucellosis / complications*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification
  • Osteomyelitis / diagnosis
  • Osteomyelitis / drug therapy
  • Osteomyelitis / microbiology*
  • Osteomyelitis / surgery
  • Retrospective Studies
  • Spine / microbiology*
  • Spine / surgery
  • Staphylococcal Infections / complications
  • Staphylococcus aureus / isolation & purification
  • Treatment Outcome
  • Tuberculosis / complications

Substances

  • Anti-Bacterial Agents