Spondilodiskit Etkenlerinin Klinik ve Radyolojik Özellikleri

Öz

Amaç: Görülme sıklığı giderek artan spondilodiskitlerde etkene yönelik antibiyoterapiye erken başlanması, komplikasyonları ve mortaliteyi azaltmak açısından önemlidir. Bu çalışmada spondilodiskit etkeni mikroorganizmaların klinik ve radyolojik özelliklerinin belirlenmesi amaçlandı. Gereç ve Yöntemler: Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği'nde 2015-2023 yılları arasında spondilodiskit tanısıyla yatırılan hastalar retrospektif olarak değerlendirildi. Bulgular: Toplam 40 hastanın %97,5'inde en sık semptom olarak bel ağrısı vardı. Hastaların 21'inde (%52,5) doku biyopsi kültür sonucu elde edildi, beşinde (%12,5) kültür pozitifliği görüldü. Anamnezde çiğ süt/süt ürünleri tüketimi ve ateş, brusellozlu hastalarda istatistiksel olarak anlamlı derecede yüksek bulundu (p<0,001, p=0,015), nörolojik defisitler ise piyojenik grupta anlamlı olarak daha yüksekti (p=0,007). Brusella ve piyojenik spondilodiskit için ayırt edici klinik ve radyolojik parametre saptanmadı. Sonuçlar: Spondilodiskit tanılı hastalarda özellikle endemik bölgelerde bruselloz için serolojik testler istenmelidir. Patojen izolasyonundan önce ampirik antibiyotik kullanımı, tanıda ve uygun tedavide gecikmelere neden olabilir ve nörolojik defisitler gibi komplikasyonlara yol açabilir.

Anahtar Kelimeler

• spondilodiskit
• bruselloz
• pyojenik

Clinical and Radiological Features of Pyogenic and Brucellar Spondylodiscitis

Öz

Aim: Since spondylodiscitis continues to be seen with increasing incidence; thus, starting antibiotherapy targeted towards the etiological agent is crucial for reducing complications and mortality. This study aimed to determine the clinical and radiological characteristics of spondylodiscitis’ causative microorganisms. Material and Methods: Patients hospitalized in the Department of Infectious Diseases and Clinical Microbiology with a diagnosis of spondylodiscitis between 2015 and 2023 were retrospectively evaluated. Results: Low back pain was present in 97.5% of the total 40 patients as the most common symptom. Tissue biopsy culture results were obtained for 21 (52.5%) patients, with culture positivity observed in five (12.5%) patients. Consumption of raw milk/dairy products in the anamnesis and fever were found to be statistically significantly higher in patients with brucellosis (p < 0.001, p = 0.015), whereas neurological deficits were significantly higher in the pyogenic group (p = 0.007). No significant differences were observed between the pyogenic and brucella spondylodiscitis groups in terms of laboratory parameters (sedimentation rate, C-reactive protein, white blood cell count) and magnetic resonance imaging findings. Conclusion: Since no distinctive clinical and radiological parameters were identified for distinguishing between brucellar and pyogenic spondylodiscitis, serological tests for brucellosis should be investigated when considering the diagnosis, particularly in endemic regions. In cases of pyogenic spondylodiscitis, empirical antibiotic use prior to pathogen isolation may lead to delays in diagnosis and appropriate treatment, potentially resulting in complications such as neurological deficits. Therefore, interventional methods for tissue biopsy culture should be planned before antibiotherapy, especially in patients who do not immediately require antibiotherapy.

Anahtar Kelimeler

• spondylodiscitis
• brucellosis
• pyogenic

Kaynakça

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