Osteoarticular brucellosis in children.

Abstract

The findings in 40 children (24 female, 16 male) with osteoarticular complications of bruceliosis are presented. Raw milk was the main source of infection. Most patients had acute onset of fever, arthralgia, and myalgia. Arthritis was the presenting symptom in all patients, of whom two also had osteomyelitis. Arthritis was monoarticular in 28 (70%) of 40 cases with predilection for large weight-bearing joints. Spine and smali joints were spared.Brucella melitensis was detected in 23/31 (74%) cases. Mild anaemia, leucopenia, increased liver enzymes, positive acute phase reactants, and low titres of autoantibodies were prominent non-specific laboratory findings. Bone scintigraphy was more helpful than conventional radiography in detecting hip and sacroiliac joint disease. Treatment with a combination of antibiotics for six weeks or more resulted in a cure rate of 92-5%. Early recognition of infection, prolonged treatment, and long term follow up should improve the outcome of patients.

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

“…Brucella species are intracellular inhabitants, very di cult to isolate from body¯uids in which they are freed intermittently. 16 Thus it is usually recommended to isolate the microorganism from tissue cultures rather than body¯uids. A CT guided aspiration of the paravertebral abscess may be a useful diagnostic technique but the procedure requires experienced interventional radiologists.…”

Vertebral Osteomyelitis and Paraspinal Abscess Among Patients With Brucellosis

“…Bones are normally resistant to infections. However, Brucella infection has aspecial tropism for osteoarticular involvement and osteoarticular brucellosis is the most common localization of active disease (2,3,(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Focal osteomyelitis of the vertebrae, tibia and especially the knees has also been reported with brucellosis infection even in the absence of other significant systemic symptoms (1, 4, 12-14).…”

“…Sanaei-Dashti reported that sacroiliitis is the most common form of the skeletal involvement of brucellosis in adults yet we had no patients with sacroiliitis involvement and most of them showed spondylitis in lumbar vertebra (14). al-Eissa observed no patient with brucellosis spondylitis among 40 children with skeletal complications (15). In a study by Geyik, 24.59% of adults and 17.9% of children who were suffering from skeletal complications of brucellosis had spondylitis (16).…”

“…Tissue damage may happen due to a direct invasion of brucella infection on osteoblasts. Sometimes, this damage occurs as a result of persistent inflammatory response during infection (14)(15)(16). Among our patients osteoarticular involvement was the most common complication (19%).…”

SACROILIITIS AS PRESENTATION OF SYSTEMIC DISEASE (Two Case reports)

“…Blood culture remains an important investigation and is to be collected preferably in Castenada biphasic medium maintaining meticulous asepsis during the procedure. Treatment with a combination of streptomycin plus tetracyclines or rifampicin results in rapid cure rate and resolution of arthritis without sequelae [4]. In subacute cases, pain in the hip joint may sometimes only be elicited by the Gaenslen and FABERE (Flexion, Abduction, External rotation and Extension) manouvre [2].…”