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Updated: Apr 30, 2026
06:23
Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
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Vertebral osteomyelitis: clinical features and diagnosis
S Eren Gök1, E Kaptanoğlu, A Celikbaş
1Infectious Diseases and Clinical Microbiology Clinic, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Summary
Brucellar and tuberculous vertebral osteomyelitis often present with delayed diagnoses. Key predictors for differentiating these conditions include patient history, physical exam findings, and specific imaging results for accurate diagnosis and treatment.
Area of Science:
- Infectious Diseases
- Orthopedics
- Radiology
Background:
- Vertebral osteomyelitis (VO) is a serious spinal infection requiring accurate diagnosis.
- Brucellar (BVO), tuberculous (TVO), and pyogenic (PVO) forms have distinct clinical presentations and diagnostic challenges.
- Timely differentiation is crucial for effective treatment and patient outcomes.
Purpose of the Study:
- To delineate the clinical and diagnostic features of VO subtypes for improved differential diagnosis.
- To identify predictors for distinguishing between BVO, TVO, and PVO.
Main Methods:
- Prospective observational study conducted from 2002-2012 with 214 VO patients.
- Data collection included clinical presentation, diagnostic tests, and follow-up (6 months to 3 years).
- Statistical analysis to identify predictors for each VO subtype.
Main Results:
- TVO diagnosis was significantly delayed (266 days) compared to BVO (115 days) and PVO (151 days).
- Predictors for BVO included unpasteurized cheese consumption, husbandry, sweating, arthralgia, hepatomegaly, elevated ALT, and lumbar MRI findings.
- Predictors for TVO included thoracic MRI involvement and a positive tuberculin skin test (>15 mm).
- Predictors for PVO included a history of spinal surgery and leukocytosis.
Conclusions:
- Brucellar and tuberculous vertebral osteomyelitis are leading causes of VO, often associated with diagnostic delays.
- Specific clinical, laboratory, and imaging findings are valuable predictors for differentiating BVO, TVO, and PVO.
- Identifying these predictors can guide differential diagnosis and treatment strategies for vertebral osteomyelitis.
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