Subject(s)
Aspergillus fumigatus/isolation & purification , Hydrocephalus/etiology , Neuroaspergillosis/complications , Antifungal Agents/therapeutic use , Cerebrospinal Fluid Shunts , Colitis, Ulcerative/complications , Colitis, Ulcerative/drug therapy , Combined Modality Therapy , Drainage , Fatal Outcome , Fungemia/etiology , Fungemia/microbiology , Humans , Hydrocephalus/microbiology , Hydrocephalus/surgery , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Intracranial Embolism/etiology , Invasive Pulmonary Aspergillosis/complications , Invasive Pulmonary Aspergillosis/drug therapy , Male , Middle Aged , Neuroaspergillosis/diagnosis , Neuroaspergillosis/drug therapy , Neuroaspergillosis/surgery , Prednisone/adverse effects , Prednisone/therapeutic useABSTRACT
Vertebral osteomyelitis or spondylodiscitis is an uncommon, mainly hematogenous, disease that usually affects adults. The incidence of this condition has steadily risen in recent years because of increases in spine surgery and nosocomial bacteremia, aging of the population, and intravenous drug addiction. Pyogenic infection due to Staphylococcus aureus is the most frequent form of the disease, but tuberculosis and brucellosis are still common causes of spondylitis in Spain. The clinical presentation is nonspecific and the diagnosis is often delayed. Magnetic resonance imaging is the most sensitive radiologic technique for this disease. Blood cultures are often positive, but computed tomography-guided needle biopsy or surgical biopsy of the affected vertebra is sometimes required to achieve a microbiological diagnosis. Prolonged antibiotic therapy and occasionally surgery are essential for cure in most patients, and both factors have contributed to a reduction in the morbidity and mortality of the disease in recent years.
Subject(s)
Arthritis, Infectious , Osteomyelitis , Spondylitis , Algorithms , Anti-Bacterial Agents/therapeutic use , Arthritis, Infectious/diagnosis , Arthritis, Infectious/epidemiology , Arthritis, Infectious/microbiology , Arthritis, Infectious/therapy , Brucellosis/diagnosis , Brucellosis/epidemiology , Brucellosis/therapy , Combined Modality Therapy , Cross Infection/diagnosis , Cross Infection/epidemiology , Cross Infection/microbiology , Cross Infection/therapy , Debridement , Diagnostic Imaging , Discitis/diagnosis , Discitis/epidemiology , Discitis/microbiology , Discitis/therapy , Drainage , Humans , Osteomyelitis/diagnosis , Osteomyelitis/epidemiology , Osteomyelitis/microbiology , Osteomyelitis/therapy , Prognosis , Spain/epidemiology , Spinal Fusion , Spondylitis/diagnosis , Spondylitis/epidemiology , Spondylitis/microbiology , Spondylitis/therapy , Staphylococcal Infections/diagnosis , Staphylococcal Infections/epidemiology , Staphylococcal Infections/therapy , Surgical Wound Infection/diagnosis , Surgical Wound Infection/epidemiology , Surgical Wound Infection/microbiology , Surgical Wound Infection/therapy , Tuberculosis, Spinal/diagnosis , Tuberculosis, Spinal/epidemiology , Tuberculosis, Spinal/therapyABSTRACT
La osteomielitis vertebral o espondilodiscitis es una enfermedad poco frecuente que suele afectar a adultos. Su incidencia ha aumentado en los últimos años debido a la mayor frecuencia de procedimientos quirúrgicos espinales y de bacteriemia nosocomial, el envejecimiento de la población y la adicción a drogas intravenosas. La infección hematógena es la causa más común de espondilitis. La infección piógena, producida por Staphylococcus aureus, es la forma más frecuente de enfermedad, aunque la tuberculosis y la brucelosis son todavía una etiología frecuente en nuestro país. La presentación clínica es inespecífica, lo que condiciona un gran retraso diagnóstico. La resonancia magnética es la técnica de imagen más sensible. Los hemocultivos son, con frecuencia, positivos, pero suele ser necesaria la biopsia vertebral quirúrgica o guiada por tomografía para conseguir el diagnóstico microbiológico. El tratamiento antibiótico prolongado y ocasionalmente la cirugía son esenciales para conseguir la curación en la mayoría de los enfermos y ambos factores han contribuido a la reducción de su morbimortalidad en los últimos años (AU)
Vertebral osteomyelitis or spondylodiscitis is an uncommon, mainly hematogenous, disease that usually affects adults. The incidence of this condition has steadily risen in recent years because of increases in spine surgery and nosocomial bacteremia, aging of the population, and intravenous drug addiction. Pyogenic infection due to Staphylococcus aureus is the most frequent form of the disease, but tuberculosis and brucellosis are still common causes of spondylitis in Spain. The clinical presentation is nonspecific and the diagnosis is often delayed. Magnetic resonance imaging is the most sensitive radiologic technique for this disease. Blood cultures are often positive, but computed tomography-guided needle biopsy or surgical biopsy of the affected vertebra is sometimes required to achieve a microbiological diagnosis. Prolonged antibiotic therapy and occasionally surgery are essential for cure in most patients, and both factors have contributed to a reduction in the morbidity and mortality of the disease in recent years (AU)
Subject(s)
Humans , Spondylitis/microbiology , Staphylococcal Infections/microbiology , Osteomyelitis/microbiology , Discitis/microbiology , Staphylococcus aureus/pathogenicity , Anti-Bacterial Agents/therapeutic useSubject(s)
Enterococcus faecium/drug effects , Gram-Positive Bacterial Infections/microbiology , Meningitis, Bacterial/microbiology , Vancomycin Resistance , Female , Gram-Positive Bacterial Infections/drug therapy , Humans , Meningitis, Bacterial/drug therapy , Middle Aged , Postoperative Period , SpainABSTRACT
No disponible
Subject(s)
Female , Middle Aged , Humans , Meningitis/microbiology , Enterococcus faecium/pathogenicity , Vancomycin Resistance , Postoperative ComplicationsSubject(s)
AIDS Arteritis, Central Nervous System/complications , Aneurysm, Infected/complications , Aneurysm, Ruptured/complications , Endocarditis, Bacterial/complications , Hematoma, Subdural/etiology , Intracranial Aneurysm/complications , Staphylococcal Infections/complications , Subarachnoid Hemorrhage/etiology , Substance Abuse, Intravenous/complications , Unconsciousness/etiology , Adult , Aneurysm, Infected/microbiology , Aneurysm, Ruptured/microbiology , Anisocoria/etiology , Bacteremia/complications , Embolism/etiology , Emergencies , Endocarditis, Bacterial/diagnosis , Fatal Outcome , Humans , Intracranial Aneurysm/microbiology , Male , Splenic Diseases/etiologyABSTRACT
No disponible
