Comparative Analysis of Tuberculous, Brucellar, and Pyogenic Spondylodiscitis: A Retrospective Evaluation of 114 Cases.

INTRODUCTION: Spondylodiscitis is an infection of the vertebral bodies, most commonly caused by pyogenic bacteria, Mycobacterium tuberculosis and Brucella spp. The infection is usually spread by hematologic route. The aim of this study was to compare the clinical, laboratory and radiologic characteristics of patients diagnosed with tuberculous (TS), brucellar (BS) and pyogenic (PS) spondylodiscitis.

MATERIALS AND METHODS: Between 2010 and 2024, 114 adult patients with spondylodiscitis were evaluated retrospectively. Diagnoses were based on microbiologic and radiologic findings. Clinical improvement, treatment response and radiological improvement were analysed. In statistical analysis, p&#x2009;<&#x2009;0.05 was considered significant.

RESULTS: PS was diagnosed in 78% of the patients, TS in 16% and BS in 6%. The duration of complaints was longer and night sweats were more frequent in the TS group. Leucocytosis was significant in the PS group. Thoracic involvement and presence of abscess were more common in the TS group. There was no significant difference between the groups in terms of sequelae, death and radiologic recovery time.

DISCUSSION: TS can be differentiated by longer symptom duration, night sweats, thoracic involvement and presence of abscess. S. aureus is the causative agent in most pyogenic cases. Clinical, laboratory and radiologic findings are important in guiding diagnosis and treatment.