A Detailed Analysis of Clinical Features and Outcomes of Patients with Pyogenic Spondylodiscitis Presenting without Axial Back Pain
Study design: Retrospective analysis of a single institution prospective, longitudinal database of spinal pyogenic infections. Diagnosis of pyogenic spondylodiscitis (PS) can be challenging. Although presenting symptoms are often non-specific, acute non-remitting axial back pain is the most striking...
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MDPI AG
2021-04-01
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| Series: | Tropical Medicine and Infectious Disease |
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| Online Access: | https://www.mdpi.com/2414-6366/6/2/54 |
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| author | Luigi Aurelio Nasto Massimo Fantoni Valerio Cipolloni Luca Piccone Enrico Pola Alfredo Schiavone Panni |
| author_facet | Luigi Aurelio Nasto Massimo Fantoni Valerio Cipolloni Luca Piccone Enrico Pola Alfredo Schiavone Panni |
| author_sort | Luigi Aurelio Nasto |
| collection | DOAJ |
| description | Study design: Retrospective analysis of a single institution prospective, longitudinal database of spinal pyogenic infections. Diagnosis of pyogenic spondylodiscitis (PS) can be challenging. Although presenting symptoms are often non-specific, acute non-remitting axial back pain is the most striking feature. Nevertheless, several authors have reported on the uncommon occurrence of patients with PS without axial back pain. The aim of this study was to characterize presenting symptoms, causative agents, comorbidities, and treatment outcomes of patients presenting with painless pyogenic spondylodiscitis. A total of 214 patients diagnosed with PS were reviewed; patients were divided into two groups: patients presenting with no axial back pain (<i>no pain group</i>, n = 16), and patients presenting with axial back pain (<i>control group</i>, n = 198). Analyzed data comprised general demographics, presenting symptoms, comorbidities, spinal infection location, and amount of spinal involvement. While average age (62.4 vs. 65.0) and sex distribution was similar between the two groups, a significant diagnostic delay was noted in the control group (53 vs. 17 days, <i>p</i> < 0.001). Patients in the no pain group were more likely IV drug abusers or have had liver failure/cirrhosis. Anatomic distribution (i.e., cervical vs thoracolumbar) of the infection did not differ between the two groups, but a higher number of post-surgical infections was noted in the no pain group (37.5 vs. 15.6%, <i>p</i> = 0.026). <i>E. coli</i> and Pseudomonas spp. were more commonly seen in no pain group patients, and mortality was also higher in this group (12.5 vs. 6.0%, <i>p</i> = 0.004). |
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| last_indexed | 2024-03-10T12:10:28Z |
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| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-48326a445d0f41c1983cc0808d0f9f1b2023-11-21T16:15:37ZengMDPI AGTropical Medicine and Infectious Disease2414-63662021-04-01625410.3390/tropicalmed6020054A Detailed Analysis of Clinical Features and Outcomes of Patients with Pyogenic Spondylodiscitis Presenting without Axial Back PainLuigi Aurelio Nasto0Massimo Fantoni1Valerio Cipolloni2Luca Piccone3Enrico Pola4Alfredo Schiavone Panni5Department of Paediatric Orthopaedics, IRCCS Istituto “G. Gaslini”, via G. Gaslini 5, 16147 Genoa, ItalyDepartment of Infectious Disease, “A. Gemelli” University Hospital, Università Cattolica del Sacro Cuore di Roma, l.go A. Gemelli 1, 00168 Rome, ItalyDepartment of Trauma and Orthopaedics, “A. Gemelli” University Hospital, Università Cattolica del Sacro Cuore di Roma, l.go A. Gemelli 1, 00168 Rome, ItalyDepartment of Trauma and Orthopaedics, “A. Gemelli” University Hospital, Università Cattolica del Sacro Cuore di Roma, l.go A. Gemelli 1, 00168 Rome, ItalyDepartment of Trauma and Orthopaedics, “A. Gemelli” University Hospital, Università Cattolica del Sacro Cuore di Roma, l.go A. Gemelli 1, 00168 Rome, ItalyDepartment of Orthopaedics, A.O.U. “Vanvitelli” University Hospital, “Luigi Vanvitelli” University, Via del Sole 10, 80138 Naples, ItalyStudy design: Retrospective analysis of a single institution prospective, longitudinal database of spinal pyogenic infections. Diagnosis of pyogenic spondylodiscitis (PS) can be challenging. Although presenting symptoms are often non-specific, acute non-remitting axial back pain is the most striking feature. Nevertheless, several authors have reported on the uncommon occurrence of patients with PS without axial back pain. The aim of this study was to characterize presenting symptoms, causative agents, comorbidities, and treatment outcomes of patients presenting with painless pyogenic spondylodiscitis. A total of 214 patients diagnosed with PS were reviewed; patients were divided into two groups: patients presenting with no axial back pain (<i>no pain group</i>, n = 16), and patients presenting with axial back pain (<i>control group</i>, n = 198). Analyzed data comprised general demographics, presenting symptoms, comorbidities, spinal infection location, and amount of spinal involvement. While average age (62.4 vs. 65.0) and sex distribution was similar between the two groups, a significant diagnostic delay was noted in the control group (53 vs. 17 days, <i>p</i> < 0.001). Patients in the no pain group were more likely IV drug abusers or have had liver failure/cirrhosis. Anatomic distribution (i.e., cervical vs thoracolumbar) of the infection did not differ between the two groups, but a higher number of post-surgical infections was noted in the no pain group (37.5 vs. 15.6%, <i>p</i> = 0.026). <i>E. coli</i> and Pseudomonas spp. were more commonly seen in no pain group patients, and mortality was also higher in this group (12.5 vs. 6.0%, <i>p</i> = 0.004).https://www.mdpi.com/2414-6366/6/2/54pyogenic spondylodiscitisspinal infectionsmicrobiology of spinal infectionsclassifications of spinal infectionssurgical treatment of pyogenic spondylodiscitis |
| spellingShingle | Luigi Aurelio Nasto Massimo Fantoni Valerio Cipolloni Luca Piccone Enrico Pola Alfredo Schiavone Panni A Detailed Analysis of Clinical Features and Outcomes of Patients with Pyogenic Spondylodiscitis Presenting without Axial Back Pain Tropical Medicine and Infectious Disease pyogenic spondylodiscitis spinal infections microbiology of spinal infections classifications of spinal infections surgical treatment of pyogenic spondylodiscitis |
| title | A Detailed Analysis of Clinical Features and Outcomes of Patients with Pyogenic Spondylodiscitis Presenting without Axial Back Pain |
| title_full | A Detailed Analysis of Clinical Features and Outcomes of Patients with Pyogenic Spondylodiscitis Presenting without Axial Back Pain |
| title_fullStr | A Detailed Analysis of Clinical Features and Outcomes of Patients with Pyogenic Spondylodiscitis Presenting without Axial Back Pain |
| title_full_unstemmed | A Detailed Analysis of Clinical Features and Outcomes of Patients with Pyogenic Spondylodiscitis Presenting without Axial Back Pain |
| title_short | A Detailed Analysis of Clinical Features and Outcomes of Patients with Pyogenic Spondylodiscitis Presenting without Axial Back Pain |
| title_sort | detailed analysis of clinical features and outcomes of patients with pyogenic spondylodiscitis presenting without axial back pain |
| topic | pyogenic spondylodiscitis spinal infections microbiology of spinal infections classifications of spinal infections surgical treatment of pyogenic spondylodiscitis |
| url | https://www.mdpi.com/2414-6366/6/2/54 |
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