Brucellar spondylodiscitis: a case report

Aydın, Gülümser; Tosun, Ayşe İstanbullu; Keleş, İbrahim; Ayaslioglu, Ergin; Tosun, Özgür; Orkun, Sevı̇m

doi:10.1111/j.1742-1241.2005.00656.x

Cited by 23 publications

(38 citation statements)

References 9 publications

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“…Tedavide doksisiklin, tetrasiklin, rifampisin, siprofloksasin, ofloksasin, trimetoprim-sülfametoksazol ve aminoglikozidlerden (örneğin gentamisin, streptomisin) oluşan ikili veya üçlü kombinasyon tedavileri kullanılabilmektedir (41,42).…”

Section: Tedaviunclassified

Osteoarticular Brucellosis

Günal¹,

Ülger²,

Barut³

et al. 2011

Klimik Dergisi

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ÖzetBruselloz, özellikle Akdeniz ve Orta Asya ülkeleri olmak üzere dünya üzerinde yaygın dağılım gösteren, Brucella cinsindeki bakterilerle oluşan, değişik organ ve sistemleri etkileyen, sistemik infeksiyöz bir hastalıktır. İnsanlara sıklıkla infekte hayvan ürünleri, pastörize edilmemiş süt veya süt ürünlerinin tüketi-mi, infekte hayvanlarla direkt temas veya inhalasyon yoluyla bulaşır. Primer olarak retiküloendotelyal sistem hastalığı olan brusellozda, en sık (%20-60) osteoartiküler tutulum (spondilit, periferik artrit, sakroiliit ve osteomyelit) görülür. AbstractBrucellosis, prevalent especially in Mediterranean and Central Asian countries, is a systemic infectious disease which affects different organs and systems and is caused by the bacteria of the Brucella genus. It is often transmitted to humans through infected animal products, consumption of milk and milk products which are not pasteurized or direct contact with the infected animals or inhalation. Osteoarticular involvement (peripheral arthritis, spondylitis, sacroiliitis, and osteomyelitis) is often seen (20-60%) in brucellosis, which is primarily a reticuloendothelial system disease. In this article, osteoarticular involvement of brucellosis and radiologic diagnostic methods are reviewed. Klimik Dergisi 2011; 24(2): 76-81.Key Words: Brucellosis, osteoarticular involvement. Girişİnsan brusellozu çoğul organ tutulumu ile seyreden ve yaşamı tehdit edebilen bir hastalıktır. Brucella türleri intraselüler olarak, özellikle retiküloendotelyal sistemde (RES) yerleşmektedir (1).Bruselloz, hâlâ ciddi bir infeksiyon hastalığı olup, insan ve hayvanlarda önemli bir morbidite nedeni olmayı sürdürmektedir. Başta Akdeniz ve Orta Asya ülkeleri olmak üzere dünyanın hemen her yerinde ve her yaşta görülebilir (2). Ülkemiz brusellozun endemik olarak rapor edildiği bir ülkedir. Sağlıklı popülasyonda bruselloz seropozitifliği %2-8 arasında gözlenirken, risk grupların-da seropozitiflik %2-25 arasında değişen oranlarda göz-lenmektedir (3).Etken, Gram-negatif, sporsuz, hareketsiz, küçük kokobasil yapısında bakterilerdir. Islak ve nemli ortamlarda kolay ürerler, bu yüzden çiğ süt ve süt ürünlerinde uzun süre kalabilirler. Kaynatmakla ve pastörizasyonla inaktive olurlar (4).Tüm dünyada bruselloz vakalarında en sık izole edilen tür B. melitensis'tir. En sık rastlanan rezervuarları ise koyun ve keçilerdir. B. abortus özellikle sığırlarda bulunurken, B. suis yerel olarak görülür ve yaban domuzlarında sık olarak gözlenir. B. canis pek çok ülkede köpek-lerde gözlenir; ancak insan infeksiyonu nadirdir (5).Bruselloz, primer olarak hayvanlarda bulunup insanlara bulaşma, pastörize edilmemiş süt ve süt ürünlerinin tüketimi, infekte hayvanların sekresyonlarının bütünlü-ğü bozulmuş deriyle direkt teması, infekte aerosollerin inhalasyonu veya konjunktivaya inokülasyonuyla olmaktadır (6).Kan transfüzyonu ve kemik iliği nakliyle de bulaştığı bildirilmiştir (7). Solunum yoluyla bulaşabildiği için la-

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Section: Tedaviunclassified

Osteoarticular Brucellosis

Günal¹,

Ülger²,

Barut³

et al. 2011

Klimik Dergisi

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“…The non-specific and commonly subtle nature of the symptoms results in difficulty of establishing an early diagnosis. In a patient suspected of having brucellosis, a detailed history taking of direct contact with infected animals or consumption of their products is important for early diagnosis and treatment (1,3). In our case, confirming the patient's vocation and history on recent contract of brucellosis infected cow enabled us to make early diagnosis and to initiate the treatment.…”

Section: Case Reportmentioning

confidence: 99%

“…Brucella species are facultative intracellular, non-encapsulated, non-motile, and gram-negative coccobacilli, which are transmitted by the consumption of unpasteurized milk and dairy products or by direct contact with infected animals (1). Brucellosis still remains as a major health problem causing a high degree of morbidity and economic loss in many regions, particularly in the Mediterranean, Middle East, and Latin America, but it is rare in Korea (2).…”

Section: Introductionmentioning

confidence: 99%

MRI Findings of Brucellar Spondylitis: A Case Report

Kim

2013

J Korean Soc Radiol

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Brucellosis is a systemic infectious disease, and musculoskeletal involvement is a frequent complication. Particularly, spondylitis is a common involvement. However, early diagnosis of brucellar spondylitis is often difficult due to non-specific clinical symptoms and long latent period. Especially in Korea, where tuberculosis is an endemic disease, differentiation between tuberculous and brucellar spondylitis is clinically and radiologically more challenging. A 59-year-old male cattle farmer, who presented with non-specific back pain, had spondylitis on magnetic resonance imaging (MRI), and serologic test finally confirmed brucellar spondylitis. Therefore, we report a case of a rather rare disease in Korea, brucellar spondylitis with a review of MRI findings. tigue, sweating, anxiety or depression, and hepatobiliary or gastrointestinal abnormalities (5). The non-specific and commonly subtle nature of the symptoms results in difficulty of establishing an early diagnosis. In a patient suspected of having brucellosis, a detailed history taking of direct contact with infected animals or consumption of their products is important for early diagnosis and treatment (1, 3). In our case, confirming the patient's vocation and history on recent contract of brucellosis infected cow enabled us to make early diagnosis and to initiate the treatment. Index termsBrucellosis may affect various body organs, and spondylitis is the most prevalent and important complication of brucellosis in adults with frequency ranging from 2% to 50% (6). The lumbar region is the most frequent site of occurrence, whereas the cervical region is the least affected site of brucellar spondylitis (5).Definite diagnosis of brucellosis is established by clinical manifestations and the isolation of brucella species from blood or bone marrow cultures (1, 2). In the absence of bacteriologic confirmation, a positive serology for brucella (titer over 1 : 160 in a standard tube agglutinin test or a 4-fold rise in brucella-antibody titer in the interval of 2 weeks) is considered definite diagnosis (2). Particularly in Korea, because tuberculosis is an endemic disease, tuberculous or brucella infections of the spine can be confusing. Both are caused by intracellular pathogens, which are difficult to isolate or identify in a short period (4). Although ESR is not a useful indicator for the diagnosis of brucellar spondylitis, elevated ESR has been observed in a majority of lands) using a spine coil. Axial and sagittal T1 and T2 weighted images and short-tau inversion recovery were obtained via MRI scanners. Also, T1 axial and sagittal contrast enhanced images were obtained. Lumbosacral spine MRI showed low signal intensity in L2 and L3 vertebral bodies on T1 weighted image and heterogeneous high signal intensity on T2 weighted image (Fig. 1A, B). In contrast, patchy heterogeneous irregular enhancement was detected in the affected L2 and L3 vertebral bodies.Disc space narrowing was not definitely detected, but minimal endplate involvement was seen in the anterior p...

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“…Among osteoarticular complications, spondylodiscitis is a frequent and serious complication of brucellosis. Antibiotic treatment is mostly successful in early stages with no or minor neurological deficits; however, diagnosis may be delayed, due to the insidious onset of symptoms, development of abscess formation in the adjacent tissues, and disabiling neurological deficits [9][10][11]. Thus, early diagnosis is important.…”

Section: Introductionmentioning

confidence: 99%

Spondylodiscitis: a common complication of brucellosis

Kutlu

Tuzun

et al. 2018

J Infect Dev Ctries

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Introduction: Brucellar spondylodiscitis is a frequent and serious complication of brucellosis. The aim of this study is to describe the brucellosis patients with spondylodiscitis and the predictive factors related to spondylodiscitis in brucellosis. Methodology: Laboratory-confirmed brucellosis patients from a low-to medium-endemic region were enrolled in the study and distributed into two groups. Group I consisted of patients with spondylodiscitis and Group II patients had no complications. Both groups were compared for predictive factors of spondylodiscitis. Results: A total of 219 patients with active brucellosis were included in the study. We determined at least one complication in 91 (41.6%) patients. The most frequent complication was spondylodiscitis [n = 59 patients (26.9 %)]. In univariate analysis, age, time from symptom onset to diagnosis, presence of low back pain, increased levels of erythrocyte sedimentation rate, and alkaline phosphatases were the most significant predictive factors for spondylodiscitis among brucellosis cases. Presence of headache and thrombocytopenia were less frequent in patients with spondylodiscitis when compared to patients without complications (p = 0.024, p = 0.006 respectively). In multivariate analysis, old age (odds ratio [OR] 1,063; 95% confidence interval [CI] 1.026-1.101; p < 0.001), prolonged time between symptoms onset before diagnosis (OR 1.008; 95% CI 1.001-1.016; p = 0.031), and presence of low back pain (OR 12.886;; p < 0.001) were indepedently associated with an increased risk of spondylodiscitis. Conclusions: Spondylodiscitis is the most frequent complication of systemic brucellosis. Patients with low back pain, older age, and longer duration of symptoms should be considered as candidates of potential spondylodiscitis in brucellosis.

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Brucellar spondylodiscitis: a case report

Cited by 23 publications

References 9 publications

Osteoarticular Brucellosis

Osteoarticular Brucellosis

MRI Findings of Brucellar Spondylitis: A Case Report

Spondylodiscitis: a common complication of brucellosis

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