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      Pyogenic Vertebral Osteomyelitis: Clinical Features, Diagnosis, and Treatment

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          Abstract

          Pyogenic vertebral osteomyelitis (PVO) may result in neurological deficits and sequelae, so early diagnosis and appropriate treatment are critical. Many previous studies on PVO exist, but our paper has aimed to comprehensively summarize the clinical aspects of PVO. Through review of the vast literature on the clinical research of PVO an overview of the clinical characteristics, diagnostic methods, treatment and prognosis is provided.

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          Spinal epidural abscess.

          Rabih Darouiche (2006)
          Article 0 comments Cited 158 times – based on 0 reviews     Review now
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            Pyogenic vertebral osteomyelitis: a systematic review of clinical characteristics.

            E Kakalou, A Skoutelis, P Fanourgiakis … (2009)
            Vertebral osteomyelitis is a cause of back pain that can lead to neurologic deficits if not diagnosed in time and effectively treated. The objective of this study was to systematically review the clinical characteristics of pyogenic vertebral osteomyelitis (PVO). The authors conducted a systematic review of the English literature. The inclusion criteria included studies with 10 or more subjects diagnosed with PVO based on the combination of clinical presentation with either a definitive bacteriologic diagnosis or pathological and/or imaging studies. The 14 studies that met selection criteria included 1008 patients with PVO. Of them, the majority (62%) were men, with back pain and fever as the most common presenting symptoms. Diabetes mellitus was the most common underlying medical illness, while the urinary tract was the commonest source of infection. Staphylococcus aureus was the most commonly isolated organism. Computed tomographic guided or open biopsy yielded the causative organism more often than blood cultures (77% versus 58%). Plain radiography showed abnormalities in 89% of the cases, while bone scanning and computed tomography or magnetic resonance imaging were positive in 94% of the cases, revealing lumbar as the most commonly affected area. The attributable mortality was 6%, while relapses and neurological deficits were described in the 32% and 32% of the cases, respectively. PVO is an illness of middle-aged individuals with underlying medical illnesses. Although the mortality rate is low, relapses and neurological deficits are common, making early diagnosis a major challenge for the physician.
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              Clinical practice. Vertebral osteomyelitis.

              Werner Zimmerli (2010)
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                Author and article information

                Journal
                Journal ID (nlm-ta): Korean J Spine
                Journal ID (iso-abbrev): Korean J Spine
                Title: Korean Journal of Spine
                Publisher: Korean Spinal Neurosurgery Society
                ISSN (Print): 1738-2262
                ISSN (Electronic): 2093-6729
                Publication date (Print): June 2017
                Publication date (Electronic): 30 June 2017
                Volume: 14
                Issue: 2
                Pages: 27-34
                Affiliations
                [1 ]Neuro-Oncology Clinic, National Cancer Center, Goyang, Korea
                [2 ]Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
                Author notes
                Corresponding Author: Seung-Jae Hyun, Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173beon-gil, Bundang-gu, Seongnam 13620, Korea, Tel: +82-31-787-7164, Fax: +82-31-787-4059, E-mail: hyunsj@ 123456snu.ac.kr
                Article
                Publisher ID: kjs-14-2-27
                DOI: 10.14245/kjs.2017.14.2.27
                PMC ID: 5518432
                PubMed ID: 28704905
                SO-VID: 7db09899-4bf2-46c1-bae5-8511ea30d3d2
                Copyright © Copyright © 2017 by The Korean Spinal Neurosurgery Society
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 3 April 2017
                Date revision received : 7 April 2017
                Date accepted : 20 June 2017
                Categories
                Subject: Review Article

                Keywords: pyogenic vertebral osteomyelitis,causative organism,diagnosis,antibiotic treatment,prognosis
                Data availability:
                Keywords: pyogenic vertebral osteomyelitis, causative organism, diagnosis, antibiotic treatment, prognosis

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