POS1283 SPONDILODISCITIS WITHOUT DOCUMENTED GERM: WHAT THERAPEUTIC MANAGEMENT?

Background: Spondylodiscitis (SD) is an infectious inflammation that affects the vertebrae, vertebral discs and adjacent structures. It may have a bacterial or non-bacterial etiology. Although analysis has improved identification of pathogens highly pursued, in one third cases, no organism can be identified. Objectives: The objective our work to describe epidemiological, clinical evolutionary profile SD with germ identified management. Methods: This retrospective study including 37 cases identified, collected Rheumatology Department Farhat Hached hospital Sousse, Tunisia over period 22 years (1998-2020). Results: mean age was 59.7 [18-97 years]. These were 21 men (56.76 %) 16 women (43.24 %).Spinal pain major symptom. lumbar location most frequent 56.76% cases. multifocal localization 21.62%. imaging allowed detection para abscesses -vertebral 43.24%. An epiduritis objectified 54.05%.CT-guided biopsy performed 59.46% it not conclusive. A bacteriological survey carried out came back negative. presumed tubercular staphylococcal respectively 62.16 % 18.92 %. tuberculosis origin retained view chronic evolution, multi-stage damage radiological assessment. While due presence cutaneous lesion subacute evolution. Large-spectrum antibiotic therapy initiated other cases.One case initially considered but epidural soft tissue extension then cause. evolution after initiation adequate treatment interspersed neurological complications SD. Conclusion: Our results show higher frequency considering endemicity country improvement under anti treatment. References: [1]Cornett, C. A., al. Bacterial Spine Infections Adults. Journal American Academy Orthopaedic Surgeons, 24(1), 11–18.(2016) [2]Lener, S., al Management spinal infection: review literature. Acta Neurochirurgica, 160(3), 487–496.(2018) [3]Homagk, L., SponDT (Spondylodiscitis Diagnosis Treatment): spondylodiscitis scoring system. Surgery Research, 14(1).(2019) Disclosure Interests: None declared