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Master Thesis

Présentation clinique initiale et délai diagnostique de 88 cas de spondylodiscites à pyogène

Abstract : Vertebral osteomyelitis (VO) is a rare infection with long diagnostic delay (DD) despite easier access to MRI, resulting in chronic disabling complications when DD is over 8 weeks. We describe the initial presentation of patients with pyogenic VO and identifie clinical and paraclinical criteria associated with delayed diagnosis. Bi-center prospective study conducted from 2008 to 2011. 88 cases of pyogenic VO diagnosed according to clinical criteria and MRI suggestive of SDI and microbiologically confirmed were included. Data were collected from patient admission in a standardized manner. 31 days are needed to establish the diagnosis. VO affects mostly men (sex ratio 1.93), aged 65 years on average. Diabetes or cancers are reported by nearly 20% of the sample, history of back pain by about 50%. Pain is the main symptom initially presented (85%), fever is present in 52% of cases. These two symptoms are found in equal proportion to the diagnosis. Clinical criteria significantly associated with an extension of DD are performing imaging of the spine (p = 0.041) and the initial absence of fever (p = 0.006). DD is not modified by age, history of chronic back pain (p = 0.911) or recurrent acute back pain (p = 0.182) or the organism identified. NSAID use was not associated with an increase in DD (p = 0.053) nor corticosteroids (p = 0.783).
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01471843
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  • HAL Id : dumas-01471843, version 1

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Maxime Jean. Présentation clinique initiale et délai diagnostique de 88 cas de spondylodiscites à pyogène. Médecine humaine et pathologie. 2012. ⟨dumas-01471843⟩

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