Infectious Spondylodiscitis: Experience of the Rheumatology Department

Introduction: Infectious spondylodiscitis (IS) is increasingly prevalent, presenting significant diagnostic challenges. Objectives: To investigate the epidemiological, clinical, paraclinical, bacteriological, histological, therapeutic, and prognostic characteristics of IS. Materials and Methods: This descriptive, retrospective study involved 49 patients hospitalized in a rheumatology department over a 14-year period (2004-2018) for IS management, diagnosed through clinical, radiological, histological, and bacteriological criteria. Results: The mean age of patients was 49.3 years. The male-to-female ratio was 0.6. Diabetes was the predominant comorbidity (19%). The average diagnostic delay was 5 months. Low back pain was the most common symptom (68%). General deterioration of health was observed in 45% of cases. An inflammatory syndrome was present in 88% of cases. Positive blood cultures were noted in 6 patients. Radiographic signs suggestive of IS were evident in 78.6% of cases. MRI was necessary for 80.9% of patients. Lumbar involvement was most frequent (40.5%). Disco-vertebral biopsy was performed in 26% of patients. Tuberculosis accounted for the majority of cases (52.4%). The average duration of antibiotic therapy was 6.5 months. Surgery was required in 26.2% of patients. Favorable outcomes were observed in 23.8% of cases, while 26% of patients experienced persistent neurological sequelae. Conclusion: Tuberculosis remains the predominant etiology of IS in our region. Despite advancements in imaging modalities, diagnostic delays persist, impacting both survival and functional outcomes.