gms | German Medical Science

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Deutsche Gesellschaft für Infektiologie,
Deutsche AIDS-Gesellschaft,
Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit,
Paul-Ehrlich-Gesellschaft für Chemotherapie

23.06. - 26.06.2010, Köln

Treatment of spondylodiscitis in HIV-infected patients – a comparison of conservative and operative therapy

Die Therapiestrategie der Spondylodiszitis beim HIV-Patienten – ein Vergleich operativer und konservativer Therapie

Meeting Abstract

  • R. Sobottke - Universität zu Köln, Orthopädie und Unfallchirurgie, Köln, Germany
  • J. Siewe - Universität zu Köln, Orthopädie und Unfallchirurgie, Köln, Germany
  • H. Seifert - Universität zu Köln, Institut für Medizinische Mikrobiologie, Immunologie und Hygiene, Köln, Germany
  • G. Fätkenheuer - Universität zu Köln, Klinik I für Innere Medizin, Klinische Infektiologie, Köln, Germany
  • P. Eysel - Universität zu Köln, Orthopädie und Unfallchirurgie, Köln, Germany

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010). Köln, 23.-26.06.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP73

DOI: 10.3205/10kit128, URN: urn:nbn:de:0183-10kit1287

Published: June 2, 2010

© 2010 Sobottke et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: To determine relevant clinical presentation and outcome of HIV-positive patients with spondylodiscitis as a function of the treatment.

Methods: We performed a national multicenter retrospective case series comparing operatively versus conservatively treated HIV-positive patients with spondylodiscitis presenting between 1991 und 2007.

Results: Twenty patients were included in the study. The average age of the patients at the time of admission was 43.0 years. The sex ratio m:w resulted in 2.3:1. On admission, 50% of the patients were in CDC stage C3. The CD4 T-cell count was determined as being 237.5/L on average. At the occurrence of spondylodiscitis HIV had been known for a mean 8.5 years. In altogether 75% of the cases a pathogen was found. In 3 cases, mixed infections were present. Half of the patients received surgery. In none of these patients a wound infection or a delay of wound healing could be observed. One patient died during in-patient stay. Eleven of the 19 patients could be followed up a mean 13 months after discharge. In the follow-up period further 3 patients died on an average of 45 months after discharge.

Conclusion: The occurrence of spondylodiscitis in HIVpositive patients is associated with a low CD4 T-cell count. The probability of mixed infections rises with a CD4 T-cell count 100/L. The occurrence of spondylodiscitis in HIV-positive patients is accompanied by high mortality. Operative therapy of spondylodiscitis in HIVpositive patients is not associated with an increased surgical complication rate. HIV infection or AIDS should not have an influence on decision-making regarding conservative or operative therapy of spondylodiscitis. To achieve higher number of cases and further informations we established the web-based register "spondHIVreg" (https://www.clinicalsurveys.net/).