Comparison of Pyogenic, Tuberculous and Brucellar Spondylitis during 10 Years in a Central City of Iran

Spondylitis is a serious disease caused by a variety of pathogens. The identification of spondylitis etiologies is a very important medical issue. This study was conducted to compare clinical, laboratory and radiological features of the patients with tuberculous (TS), brucellar (BS) and pyogenic spondylitis (PS) in a central city of Iran.
In this retrospective study, we obtained the data of 100 patients with spondylitis from a hospital in Arak city. The patients were divided into three groups including TS (8 cases), BS (71 cases) and PS (21 cases), based on the spondylitis etiology.
The mean age of cases with TS, BS, and PS was 67.25±20.26, 55.39±15.60 and 52.19±12.74 years, respectively. The most common clinical feature was back pain followed by fever. Twenty-one cases had psoas abscess which was more common in PS group. No significant difference regarding the involved vertebral regions was observed between the groups. Intravenous drug use, history of vertebral surgery and chronic renal failure were frequent in patients with PS, and all TS cases had pulmonary involvement.
Our data showed that presence of concomitant pulmonary involvement and a confirmed history of tuberculosis are suggestive of tuberculous spondylitis. However, the distinction between TS and BS is still problematic and only a combination of clinical data, laboratory findings, radiological features and history of TB can be helpful in differentiation of TS and BS.