Academic Journal
Predictive factors for positive disco-vertebral biopsy culture in pyogenic vertebral osteomyelitis, and impact of fluoroscopic versus scanographic guidance
| Title: | Predictive factors for positive disco-vertebral biopsy culture in pyogenic vertebral osteomyelitis, and impact of fluoroscopic versus scanographic guidance |
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| Authors: | Caroline Diffre, Camille Jousset, Anne-Laure Roux, Clara Duran, Latifa Noussair, Martin Rottman, Robert-Yves Carlier, Aurélien Dinh |
| Source: | BMC Infectious Diseases, Vol 20, Iss 1, Pp 1-9 (2020) |
| Publisher Information: | BMC, 2020. |
| Publication Year: | 2020 |
| Collection: | LCC:Infectious and parasitic diseases |
| Subject Terms: | Vertebral osteomyelitis, Fluoroscopy, DVB, MRI, Paravertebral infiltration, Infectious and parasitic diseases, RC109-216 |
| More Details: | Abstract Background The aims of this study were to identify the predictive factors for microbiological diagnosis through disco-vertebral biopsy (DVB) in patients with pyogenic vertebral osteomyelitis (PVO) and negative blood cultures, and compare the performance of DVB under fluoroscopic versus scanographic guidance. Methods We performed a cohort study comparing positive and negative DVB among patients with PVO. All cases of PVO undergoing a DVB for microbiological diagnosis in our center were retrospectively reviewed. Infections due to Mycobacterium tuberculosis, infections on foreign device, and non-septic diseases were excluded. Anamnestic, clinical, biological, microbiological, as well as radiological data were collected from medical charts thanks to a standardized data set. Results A total of 111 patients were screened; 88 patients were included. Microbiological cultures were positive in 53/88 (60.2%) patients. A thickening of the paravertebral tissue ≥10 mm on magnetic resonance imaging (MRI) in axial MR scans was a predictive factor of DVB microbiological positivity (52.4% vs. 13.3%; p = 0.006; OR = 5.4). Overall, 51 DVB were performed under fluoroscopic guidance and 37 under scanographic guidance. Considering lumbar DVB, 25/36 (69.4%) of cases yielded positive results under fluoroscopic guidance versus 5/15 (33.3%) under scanographic guidance (p = 0.02; OR = 4.4). No adverse event linked to DVB was notified. Conclusion Every patient with PVO and negative blood cultures should undergo a DVB. A thickening of the paravertebral tissue ≥10 mm on MRI is associated with a higher rate of positive DVB culture. A lumbar DVB under fluoroscopic guidance is more sensitive than under scanographic guidance to identify the micro-organism involved. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 1471-2334 96583347 |
| Relation: | http://link.springer.com/article/10.1186/s12879-020-05223-z; https://doaj.org/toc/1471-2334 |
| DOI: | 10.1186/s12879-020-05223-z |
| Access URL: | https://doaj.org/article/d56f965833474d8cad6ff678fdced9b9 |
| Accession Number: | edsdoj.56f965833474d8cad6ff678fdced9b9 |
| Database: | Directory of Open Access Journals |
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| ISSN: | 14712334 96583347 |
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| DOI: | 10.1186/s12879-020-05223-z |
| Published in: | BMC Infectious Diseases |
| Language: | English |