HIV STATUS DOES NOT AFFECT MICROBIOLOGIC SPECTRUM OR NEUROLOGIC OUTCOME IN SPINAL INFECTIONS

The impact of human immunodeficiency virus (HIV) on the clinical prese ntations, causative organisms, and neurologic outcomes of patients wit h spinal infections is reviewed. Thirty-two patients with spinal epidu ral abscesses, vertebral osteomyelitis, or both were treated at an urb an hospital over a 42-month period. Thirteen of these patients were co nfirmed by serologic analysis to be HIV seropositive. The diagnoses we re confirmed by 30 open surgical procedures (14 anterior, 16 posterior ) and seven percutaneous biopsies. Twenty-seven intraoperative culture s were positive and the remaining three patients had positive blood cu ltures prior to the surgical procedure. In both the HIV (+) and HIV (- ) groups, Staphylococcus aureus predominated as the causative organism (overall rate: 72%). Mycobacterium tuberculosis was the second most c ommon organism. The clinical presentations in both groups were similar with pain as the most frequent symptom and objective neurologic abnor malities on physical examination in 29 of the 32 patients (91%). The r esults of this analysis show that the clinical presentations and organ isms cultured do not differ depending upon a concurrent HIV infection. Furthermore, the ultimate neurologic outcome of patients with spinal infections depends on their neurologic status at the time of treatment and not on their HIV status.