Thrombosis of the abdominal aorta secondary toBrucella spondylitis

Abstract

Spondylitis is one of the most frequent osteoarticular complications of Brucella infection in adults. Occasionally it gives rise to soft tissue paravertebral or epidural masses, which can compress surrounding structures. A patient with thrombosis of the abdominal aortic artery secondary to Brucella lumbar spondylitis is presented here, a complication that has not been previously reported.

Brucella arteritis: clinical manifestations, treatment, and prognosis

“…However, when additional sites of infection were investigated, they were present in most cases. 25,28,30,38–40,44,50,54 The most common extravascular sites of infection among patients who had endarteritis were bone (87·5%), kidney (12·5%), and testes (12·5%). Despite this high proportion of focal involvement, and the increased risk of relapse with such involvement, 5 few of the published cases (37%) describe an assessment for the possibility of extravascular infection.…”

“…25 Three cases, however, had initial negative serologies that turned positive in repeated tests. 31,37 50 . Thus, if brucellosis is a strong diagnostic consideration, repetition of an initial negative serological test seems reasonable.…”

“…5,6 WHO recommends doxycycline and rifampicin for 6 weeks as standard therapy for brucellosis; however, doxycycline for 6 weeks with streptomycin for the initial 3 weeks is also an acceptable alternative, and is the regimen used for the Ioannina recommendations. 50 …”

“…The mortality rate in published cases is 21%, and many patients’ infection progressed despite adequate therapy. 32,41,50,52,55 A review of published cases suggested that several factors seem to be associated with increased likelihood of mortality with brucella arteritis. Survival seems to be lower in those infected with B suis than in those infected with other strains.…”

“…25–32, 35–45,47,49,50,52,53,55,56,57,58 Sulfa drugs include co-trimoxazole, terfonyl, and sulfanilamide.…”