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Culture Yield in the Diagnosis of Native Vertebral Osteomyelitis: A Single Tertiary Center Retrospective Case Series With Literature Review.
Weihe, Rachel; Taghlabi, Khaled; Lowrance, Maren; Reeves, Alan; Jackson, Sean R; Burton, Douglas C; El Atrouni, Wissam.
Afiliación
  • Weihe R; Division of Infectious Diseases, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.
  • Taghlabi K; Department of Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.
  • Lowrance M; Medical Informatics and Enterprise Analytics, University of Kansas Medical Center, Kansas City, Kansas, USA.
  • Reeves A; Department of Radiology, University of Kansas Medical Center, Kansas City, Kansas, USA.
  • Jackson SR; Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.
  • Burton DC; Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.
  • El Atrouni W; Division of Infectious Diseases, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.
Open Forum Infect Dis ; 9(3): ofac026, 2022 Mar.
Article en En | MEDLINE | ID: mdl-35198644
BACKGROUND: Vertebral osteomyelitis is a serious condition that requires prompt diagnosis to avoid delays in proper management. There is no well-defined gold standard for diagnosis. We describe the current diagnostic approach at our institution, with a focus on the yield of image-guided vertebral biopsy. METHODS: We performed a single-centre 10-year retrospective case series, including adults with imaging suggestive of vertebral osteomyelitis/discitis, with either positive blood cultures, and/or a vertebral biopsy. We defined positive histopathology as our gold standard for test characteristic evaluation of biopsy cultures. RESULTS: Out of 694 patients identified, 221 met our inclusion criteria, and 173/221 (78.2%) patients underwent a spinal biopsy. Of those patients with biopsies, 113 (65%) had received antibiotics within 2 weeks preceding their evaluation. Six of 43 (13.9%) bone specimens were positive by culture, while 66/152 (43.4%) of disc specimens were culture positive. Forty-seven of 84 (55.9%) histopathology (bone or disc) specimens were diagnostic for osteomyelitis/discitis. The sensitivity of bone and disk culture were 30.0% and 56.0%, respectively, with specificities of 92.8% and 75.0%, respectively. Twenty-three (13.4%) patients had repeat biopsies, including 10 bone specimens and 14 disc specimens, and 11 (47.8%) specimens had histopathology performed which diagnosed an additional 3/23 patients (13% additional diagnostic yield). CONCLUSIONS: Culture of percutaneous biopsy of disc resulted in the highest diagnostic yield. Histopathology added to the diagnostic yield in culture-negative specimens. Histopathologic evaluation of bone had better yield than bone culture. A repeat biopsy can add to the diagnostic yield.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Prognostic_studies Idioma: En Revista: Open Forum Infect Dis Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Prognostic_studies Idioma: En Revista: Open Forum Infect Dis Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos