TITLE:
Infectious Spondylodiscitis in the Elderly in a Rheumatological Setting in Togo
AUTHORS:
Kodjo Kakpovi, Awaki-Esso Atake, Prenam Houzou, Issa Diallo, Mamadou L. Diallo, Viwale E. Koffi-Tessio, Komi C. Tagbor, Sadat Oniankitan, Pahimi Yibe, Erika Djougnwe Mba, Moubarak Tiadjeri, Eyram Fianyo, Owonayo Oniankitan, Moustafa Mijiyawa
KEYWORDS:
Infection, Tuberculosis, Spondylodiscitis, Aging, Sub-Saharan Africa
JOURNAL NAME:
Open Journal of Rheumatology and Autoimmune Diseases,
Vol.12 No.1,
December
15,
2021
ABSTRACT: Infectious spondylodiscitis in
the elderly is a diagnostic and therapeutic emergency. They are mainly a functional and sometimes vital prognosis
issue, with long-term chronic disabling sequelae and significant social costs. Study aim: To describe the epidemiological, clinical, paraclinical,
therapeutic and evolutionary aspects of infectious spondylodiscitis in the
elderly in a rheumatological setting in Togo. Patients and methods: This was a multicenter, cross-sectional
study conducted on the records of patients aged at least 65 years, suffering
from infectious spondylodiscitis and hospitalized in four rheumatology units
from their respective opening dates till December 31, 2020. Data collection
lasted three months (December 1, 2020 to February 29, 2021). The diagnosis of infectious spondylodiscitis was
radioclinical and laboratory-based. Results: 83 (49 women, 34
men) of the 1281 patients (6.48%) examined had infectious spondylodiscitis. The
mean age at consultation was 70.59 ± 5.09 years, and the mean duration of the
clinical course was 12 months. Spondylodiscitis was of tuberculous etiology
(89.20%). It was most often found in the lumbar (56.62%) and dorsal (21.69%)
segments. The location was multifocal in 12.05% of cases. It was associated
with pulmonary involvement in 22.64% of cases. A neurological complication was
identified in 48.19%. The main risk factors identified were promiscuity
(48.82%), chronic alcoholism (18.07%), HIV infection (8.43%), diabetes (6.03%)
and sickle cell disease (6.03%). The clinical
course under medical treatment was favorable in 57 patients (68.68%). Conclusion: Infectious spondylodiscitis remains a frequent reason for hospitalization,
tuberculosis being the most frequent etiology. Multifocal location,
deterioration of general condition, gibbosity and neurological complications
are exclusive to the elderly subject.