Clinical characteristics of human brucellosis in patients with various monoarticular involvements

Bosilkovski, Mile; Zezoski, Marjan; Siskova, Dijana; Miskova, Silvana; Kotevska, Vesna; Labacevski, Nikola

doi:10.1007/s10067-016-3207-z

Cited by 14 publications

(14 citation statements)

References 25 publications

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“…Serological screening tests need to be conducted in all such patients[13,22,25,26], although serology may not be positive in all cases. A radionuclide scan can be a useful tool to determine the affected site[27,28]. MRI may be the best method to diagnosis and localize the cause of spondylodiscitis, epidural abscess, or compression on the spine and spinal nerves related to brucellosis.…”

Section: Osteoarticular Manifestationsmentioning

confidence: 99%

“…Knee, hip and ankle joints are among the most common peripheral regions affected by brucellosis and these patients present with arthritis[15,70]. Shoulders, wrists, elbows, interphalangeal and sternoclavicular joints may also be involved[28,69,71]. Chronic knee arthritis along with osteomyelitis have also been reported[72,73].…”

Section: Osteoarticular Manifestationsmentioning

confidence: 99%

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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%

Section: Osteoarticular Manifestationsmentioning

confidence: 99%

Osteoarticular manifestations of human brucellosis: A review

Esmaeilnejad-Ganji

2019

WJO

121

109

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“…A family history of brucellosis has been identified as a trait of brucellosis in endemic areas and reflects dietary habits and involvement in stockbreeding 31 . it is also interesting that in two of our pa-tients (cases 1 and 5), peripheral arthritis was manifested, and it is the most frequent focal form of brucellosis in this endemic region 31,32 . Clinical presentation of brucellosis in our patients comprised manifestations that are unspecific and sometimes assigned to pregnancy itself, which might be a cause for delayed establishment of the diagnosis.…”

Section: Discussionmentioning

confidence: 62%

Brucellosis in Pregnancy: Case Reports with Different Outcomes in an Endemic Region

Bosilkovski

2020

ACC

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1 medical faculty, ss Cyril and methodius university, skopje, Republic of macedonia; 2 university hospital of obstetrics and gynecology, skopje, Republic of macedonia; 3 department of infectious diseases, shtip medical Center, shtip, Republic of macedonia; 4 department of infectious diseases, Kavadarci medical Center, Kavadarci, Republic of macedonia; 5 department of infectious diseases, prilep medical Center, prilep, Republic of macedonia; 6 faculty of Veterinary medicine, ss Cyril and methodius university, skopje, Republic of macedonia summARy-different outcomes of brucellosis in pregnancy regarding the fetus/neonate and the mother are described. medical records of five pregnant women with brucellosis were retrospectively analyzed. patients were treated in several departments of infectious diseases in the Republic of macedonia between 1995 and 2009. The diagnosis of brucellosis was based on clinical findings compatible with the disease supported by detection of specific antibodies. pregnancy outcomes in patients were as follows: spontaneous abortion, intrauterine fetal death, premature delivery in two cases (one with twin pregnancy) and term delivery. one of the women experienced relapse. follow-up results of neonates showed no infection and their normal growth and development. Brucellosis, especially if acquired in early pregnancy, can have an impact on pregnancy outcome. in endemic regions, in pregnant women with persisting fever and unspecific manifestations one should always have in mind brucellosis. in these areas, cases with unexplained spontaneous abortion, intrauterine fetal death and premature delivery should also be investigated for brucellosis.

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“…The relapse rate in patients with brucellosis varies between 2.4% and 29.0% [2,3,5,6,[15][16][17] . The relapse rate in our study was 8.5%, which is consistent with the literature data.…”

Section: Discussionmentioning

confidence: 99%

Osteoarticular Involvement and Inadequate Treatment of Brucellosis Are Related with Relapse

Özger¹,

Karaşahin²,

Yıldız³

et al. 2020

mjima

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The goal of treatment in brucellosis is to control symptoms to prevent the development of complications and relapse of infection. The aim of this study was to evaluate the risk factors for relapse in brucellosis patients, including those with complications. Materials and Methods: Our study was performed retrospectively with data from three centers. Complication of brucellosis was defined as the involvement of specific anatomical regions in the disease. Recurrence of symptoms and signs of brucellosis six months after termination of treatment and increased standard tube agglutination titer under treatment or isolation of Brucella spp. in sterile body fluids was defined as relapse. Inadequate treatment duration was defined as a treatment duration of less than eight weeks in patients with osteoarticular complications and less than six weeks in other brucellosis involvement. A multivariate logistic regression model was built with the variables determined to be effective in relapse development. The logistic regression model included gender, the presence of osteoarticular complications, inadequate treatment duration, treatment combinations, and leukocyte count. The SPSS 20 statistical package program was used for statistical analysis. Results: A total of 1,296 patients were enrolled in the study. Their median age was 42 (31-54) years and 631 (48.7%) were female. One or more complications were detected in 448 (34.6%) cases. A two-drug antibiotic combination was given to 1,125 (86.8%) patients and 171 (13.2%) were treated with a three-drug antibiotic combination regimen. Three hundred sixteen (24.4%) of the patients were treated with combination therapies that included an aminoglycoside. Relapse occurred in 110 (8.5%) patients, and treatment was inadequate for 105 (8.1%) cases. Osteoarticular complications were more frequent in patients with relapse than in those without relapse (33.6% vs 18.5%, p<0.001). The presence of osteoarticular complications [odds ratio (OR): 2.413, 95% confidence interval (CI): 1.550-3.756] and inadequate treatment duration (OR: 2.861, 95% CI: 1.645-4.974) were associated with a higher rate of brucellosis relapse, while combination therapies including an aminoglycoside (OR: 0.432, 95% CI: 0.249-0.752) was associated witha lower relapse rate. Conclusion: Our results indicate that in patients with osteoarticular complications, treatment should be administered for the recommended optimal duration, and combination therapies including aminoglycosides should be chosen preferentially in order to prevent a relapse of infection.

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Clinical characteristics of human brucellosis in patients with various monoarticular involvements

Cited by 14 publications

References 25 publications

Osteoarticular manifestations of human brucellosis: A review

Osteoarticular manifestations of human brucellosis: A review

Brucellosis in Pregnancy: Case Reports with Different Outcomes in an Endemic Region

Osteoarticular Involvement and Inadequate Treatment of Brucellosis Are Related with Relapse

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