Chronic Brucella infection of the humerus diagnosed after a spontaneous fracture

Mathieu, Luc; Armingeat, Thomas; Pham, Thao; Legré, Virginie; Lafforgue, P.

doi:10.1016/j.jbspin.2007.04.024

Cited by 8 publications

(6 citation statements)

References 10 publications

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“…Delay in the diagnosis of brucellosis results in prolong disease duration which can lead to osteomyelitis or osteolytic lesions. Brucellar osteomyelitis has been observed in closed femur fracture and a pathologic humerus fracture[90,91]. It was also seen in association with prosthetic extra-articular hardware[92].…”

Section: Osteoarticular Manifestationsmentioning

confidence: 99%

Osteoarticular manifestations of human brucellosis: A review

Esmaeilnejad-Ganji

2019

WJO

121

109

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Brucellosis is a common global zoonotic disease, which is responsible for a range of clinical manifestations. Fever, sweating and musculoskeletal pains are observed in most patients. The most frequent complication of brucellosis is osteoarticular involvement, with 10% to 85% of patients affected. The sacroiliac (up to 80%) and spinal joints (up to 54%) are the most common affected sites. Spondylitis and spondylodiscitis are the most frequent complications of brucellar spinal involvement. Peripheral arthritis, osteomyelitis, discitis, bursitis and tenosynovitis are other osteoarticular manifestations, but with a lower prevalence. Spinal brucellosis has two forms: focal and diffuse. Epidural abscess is a rare complication of spinal brucellosis but can lead to permanent neurological deficits or even death if not treated promptly. Spondylodiscitis is the most severe form of osteoarticular involvement by brucellosis, and can have single- or multi-focal involvement. Early and appropriate diagnosis and treatment of the disease is important in order to have a successful management of the patients with osteoarticular brucellosis. Brucellosis should be considered as a differential diagnosis for sciatic and back pain, especially in endemic regions. Patients with septic arthritis living in endemic areas also need to be evaluated in terms of brucellosis. Physical examination, laboratory tests and imaging techniques are needed to diagnose the disease. Radiography, computed tomography, magnetic resonance imaging (MRI) and bone scintigraphy are imaging techniques for the diagnosis of osteoarticular brucellosis. MRI is helpful to differentiate between pyogenic spondylitis and brucellar spondylitis. Drug medications (antibiotics) and surgery are the only two options for the treatment and cure of osteoarticular brucellosis.

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Section: Osteoarticular Manifestationsmentioning

confidence: 99%

Osteoarticular manifestations of human brucellosis: A review

Esmaeilnejad-Ganji

2019

WJO

121

109

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“…103 When atypical slow-growing pathogens are identified, a pre-existing bone infection, pathological fracture and an immunocompromised state must be suspected. [104][105][106][107]…”

Section: Microbiologymentioning

confidence: 99%

Infection after fracture osteosynthesis – Part I

Fang

Wong

Lau

et al. 2017

J Orthop Surg (Hong Kong)

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Bone and surgical site infections after osteosynthesis are notoriously difficult to manage and pose a tremendous burden in fracture management. In this article, we use the term osteosynthesis-associated infection (OAI) to refer to this clinical entity. While relatively few surgically treated fractures become infected, it is challenging to perform a rapid diagnosis. Optimal management strategies are complex and highly customized to each scenario and take into consideration the status of fracture union, the presence of hardware and the degree of mechanical stability. At present, a high level of relevant evidence is unavailable; most findings presented in the literature are based on laboratory work and non-randomized clinical studies. We present this overview of OAI in two parts: an examination of recent literature concerning OAI pathogenesis, diagnosis and classification and a review of treatment options.

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“…Long bones are less frequently affected, while flat bones are the least often involved [16]. It has been reported that apart from the spine, brucellar lesions may appear on the femoral head, hip, humerus, tibia, knee, sacroiliac joint, shoulder, and carpals [17][18][19][20][21][22][23][24]. The evidence of the above studies was based on X-rays, CT scans and MRI imaging.…”

Section: Skeletal Pathology and Differential Diagnosismentioning

confidence: 99%

Skeletal evidence of brucellosis in a medicolegal context: A report of two cases

Zorba¹,

Eliopoulos²,

Moraitis³

2017

RJLM

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Abstract:Brucellosis is a zoonosis caused by gram-negative bacteria of the genus Brucella. Osteoarticular complications are the most frequent symptoms of brucellosis occurring in up to 40% of the cases. Two brucellosis cases submitted to the Department of Forensic Medicine and Toxicology at the National and Kapodistrian University of Athens Medical School for forensic anthropological evaluation are reported. The value of the contribution of the brucellar lesions to the location of the most likely geographic origin of two missing individuals is presented. The presence of a pathologic condition, such as brucellosis, in skeletal remains can give significant information about the biological profile of an unidentified victim and greatly enhances the chances of obtaining a positive identification.

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Chronic Brucella infection of the humerus diagnosed after a spontaneous fracture

Cited by 8 publications

References 10 publications

Osteoarticular manifestations of human brucellosis: A review

Osteoarticular manifestations of human brucellosis: A review

Infection after fracture osteosynthesis – Part I

Skeletal evidence of brucellosis in a medicolegal context: A report of two cases

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