Brucellosis of the Spine

Abstract

The spinal form of brucellosis is still a disabling disease in many countries outside North America and northern and central Europe. Fifteen consecutive cases of spinal brucellosis diagnosed and treated over a 20-year period were reviewed retrospectively. Six patients were farmers, while 10 patients had a history of ingestion of unpasteurized milk or other dairy products. A high index of suspicion is necessary for the diagnosis, since there are no pathognomonic signs or symptoms. Radiological assessment of the disease was reviewed and highlights in the differential diagnoses were stressed. The diagnosis was based on actual culture of Brucella bacilli in seven patients. The principal treatment of brucellosis of the spine is conservative, namely, immobilization and antimicrobial therapy. We have found both a combination of ofloxacin and rifampin and ofloxacin monotherapy efficient as the early regimens used in this series. Three patients had to undergo surgery, since a diagnosis could not be made in any other way.

Paravertebral abscess formation and knee arthritis due to Brucellosis in a patient with rheumatoid arthritis

“…6,8 ± 10 Although brucella spondylitis is considered a mild form of infectious spondylitis in some reports, 11,12 in others, and in our case report, it caused highly destructive lesions. 5,13 To our knowledge our case is the ®rst reported case in which two di erent diseases, brucellosis and RA are associated.…”

“…Spinal brucellosis may mimic other diseases a ecting the spine, particularly tuberculosis (TB). 1,13,14 The most frequent level of involvement in TB is mid and lower thoracic spine, with more severe destruction of the a ected vertebral bodies. Angulation deformity, paravertebral masses and osteoporosis are the most marked changes in vertebral TB.…”

Espondilodiscite brucelósica: relato de caso

“…O aspecto clínico não é muito típico, exceto pelo comprometimento vertebral circunscrito, e com freqüência a doença não se manifesta por sinais claros de inflamação e infecção 4 . Assim, a valorização de antecedentes epidemiológicos é necessária para se estabelecer o diagnóstico, pois não há sinal ou sintoma patognomônicos 17 .…”

“…E, como, a espondilodiscite causada por Brucella é indistingüível radiologicamente das causadas por outros microorganismos 17 , somente após o procedimento cirúrgico e coleta do material para exame histopatológico e bacteriológico é que se descobriu tratar-se de uma espondilodiscite brucelósica.…”

Brucellar Spine Infection-Four Case Reports-

“…[10][11][12]16,17,20) The causative agents of brucellosis are hosted by domestic animals: Brucella melitensis in goats, B. abortus in cattle, B. suis in swine, and B. canis in dogs. 6,20,24) The organism is transmitted to human beings by consuming contaminated milk products or handling infected animals and may persist for many years. 6) Osteoarticular involvement of the spine is a well-known complication of brucellosis and the spine is the most common localization.…”