Evaluation of musculoskeletal complications in the patients with brucellosis

Najafi, Narges; Davoudi, Alireza; Tayebi, Atefeh; Rouhi, Samaneh; Mokhtarpour, Babak; Ahangarkani, Fatemeh

doi:10.52547/sjku.26.2.57

Cited by 2 publications

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“…In most studies, fever and chills, arthralgia, and back pain were the most common complaints of brucellosis. 24 – 27 The higher proportions of some variables such as radiculopathy, vertebral tenderness, low back pain, and neck pain in sacroiliitis patients in this study could reflect the coincidence of spondylitis with sacroiliitis in some patients. So about 25% of sacroiliitis patients had concomitant spondylitis (data not shown).…”

Section: Discussionmentioning

confidence: 78%

Brucellar arthritis and sacroiliitis: an 8-year retrospective comparative analysis of demographic, clinical, and paraclinical features

Morovati,

Bozorgomid,

Mohammadi

et al. 2024

Therapeutic Advances in Infection

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Introduction: Brucellosis is a common global zoonotic disease with a wide range of complex and nonspecific clinical manifestations that may lead to misdiagnosis and delayed treatment. Osteoarticular involvement is the most common complaint in brucellosis. Objective: This present study aims to describe the clinical and laboratory characteristics and treatment of brucellosis patients with arthritis and sacroiliitis. Methods: This retrospective descriptive study was performed on patients presenting to a teaching hospital in Kermanshah, Iran with a diagnosis of brucellosis from 2011 to 2019. The demographic and clinical characteristics, complications, laboratory findings, and treatment were recorded during the study period. Then, the difference in the collected data was investigated between brucellosis patients with and without arthritis or sacroiliitis. Results: Of 425 patients studied, 130 (30.58%) had osteoarticular involvement. Among them, 41 (9.64%) and 58 (13.6%) patients were diagnosed with arthritis and sacroiliitis, respectively. There were no significant demographic differences between patients with and without brucellar arthritis or sacroiliitis ( p > 0.05). The patients with Brucella arthritis had a significantly higher frequency of arthralgia and radiculopathy ( p ⩽ 0.05). Sacroiliitis was significantly more common in patients with arthralgia, neck pain, and low back pain, positive flexion-abduction-external rotation (FABER) test, radiculopathy, and vertebral tenderness compared to patients without sacroiliitis ( p ⩽ 0.05), while fever and headache were significantly more common in patients without sacroiliitis ( p ⩽ 0.05). The median Wright and 2-Mercapto Ethanol titers were higher in brucellosis patients with arthritis or sacroiliitis versus patients without arthritis or sacroiliitis, but the difference was not significant ( p > 0.05). Synovial fluid had been analyzed in 20 cases. The mean white blood cell count, glucose, and protein level were 3461 ± 2.70 cells/mm3, 58.54 ± 31.43 mg/dL, and 8.6 ± 11.85 g/dL, respectively. In 80% of the subjects, neutrophil cells were predominant. There were no significant laboratory differences between patients with and without brucellar arthritis or sacroiliitis, except for a higher median platelet count in patients with arthritis and higher median levels of aspartate aminotransferase (AST) and alkaline phosphatase (ALP) in patients with sacroiliitis. Most cases of arthritis and sacroiliitis were diagnosed with ultrasound (31.8%) and FABER test (79.3%), respectively. Conclusion: Arthritis and sacroiliitis were the two most important and common manifestations of brucellar osteoarthritis with a frequency of 9.64% and 13.6%, respectively. Any complaints of low back pain and radiculopathy as well as the presence of spondylitis in patients should raise suspicion of sacroiliitis. High levels of AST and ALP and a high platelet count may be associated with brucellar sacroiliitis and arthritis, respectively. The use of imaging methods such as MRI and bone scan seems necessary for the diagnosis of sacroiliitis.

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Section: Discussionmentioning

confidence: 78%

Brucellar arthritis and sacroiliitis: an 8-year retrospective comparative analysis of demographic, clinical, and paraclinical features

Morovati,

Bozorgomid,

Mohammadi

et al. 2024

Therapeutic Advances in Infection

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“…Fever and chills, arthralgia, and low back pain have been the most common complaints of brucellosis in the most studies (22)(23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

Brucellar arthritis and sacroiliitis: an eight-year retrospective comparative analysis of demographic, clinical and paracilinical features

Sayad

Bozorgomid

Mohammadi

et al. 2022

Preprint

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Background Brucellosis is a common global zoonotic disease with a wide range of complex and non-specific clinical manifestations that may lead to misdiagnosis and delayed treatment. Osteoarticular involvement is the most common complaint in brucellosis. Methods This retrospective descriptive study was performed on patients presenting to a teaching hospital in Kermanshah, Iran with a diagnosis of brucellosis during 2011–2019. The demographic and clinical characteristics, complications, laboratory findings and treatment were recorded during the study period. Then, the difference in the collected data was investigated between brucellosis patients with and without arthritis or sacroiliitis. Results Of 425 patients, 130 (30.58%) had osteoarticular involvement. Sacroiliitis (13.6%) followed by spondylitis (12.9%) and peripheral arthritis (9.6%) was the most common type of complication. 15% of patients with Sacroillitis had spondylitis, concomitantly. There were no significant demographic differences between patients with and without brucellar arthritis or sacroiliitis. The patients with brucellar arthritis had a significantly higher frequency of arthralgia. Arthralgia, neck pain, back pain, positive Faber test, radiculopathy and vertebral tenderness were significantly more frequent in patients with Sacroiliitis; while fever and headache were significantly more common in patients without sacroiliitis. The median wright and 2ME titers were higher in brucellosis patients with arthritis or sacroiliitis versus patients without arthritis or sacroiliitis, but the difference was not significant. Synovial fluid was analyzed in 20 cases. The mean white cell count, glucose and protein level were 3461 ± 2.70, 58.54 ± 31.43 mg/dLit and 8.6 ± 11.85 g/dLit, respectively. Neutrophil cells were predominant in 80% of samples. patients with arthritis had a higher median platelet count and patients with sacroiliitis had higher median levels of AST and ALP significantly. Conclusions Arthritis and sacroiliitis had a frequency of 9.64% and 13.6%, respectively. Any complaints of low back pain and radiculopathy as well as the presence of spondylitis in patients should raise suspicion of sacroiliitis. High levels of ALP and a high platelet count may be associated with brucellar sacroiliitis and arthritis, respectively. The use of paraclinical methods such as MRI and bone scan seems necessary for diagnosis of sacroiliitis.

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Evaluation of musculoskeletal complications in the patients with brucellosis

Cited by 2 publications

References 0 publications

Brucellar arthritis and sacroiliitis: an 8-year retrospective comparative analysis of demographic, clinical, and paraclinical features

Brucellar arthritis and sacroiliitis: an 8-year retrospective comparative analysis of demographic, clinical, and paraclinical features

Brucellar arthritis and sacroiliitis: an eight-year retrospective comparative analysis of demographic, clinical and paracilinical features

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