Brucellar Spondylitis: A Detailed Analysis Based on Current Findings

Ariza, Javier; Gudiol, Francisco; Valverde, J; Pallarés, Román; Fernández-Viladrich, P; Rufí, Gabriel; L, Espadaler; Fernández-Nogués, F

doi:10.1093/clinids/7.5.656

Cited by 147 publications

(100 citation statements)

References 20 publications

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“…According to Capasso in the initial phase there is a characteristic brucellar polyserositis with a pleural, peritoneal or pericardial seat [1]. Brucella infection can cause spondylitis in the lumbar and thoracic spine, osteomyelitis in long bones and the pelvis, and arthritis [27,28]. The articular or osteoarticular localizations of brucella are actually more frequent, and some authors consider them necessary to diagnose brucellosis [1].…”

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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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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“…The disease was found to involve most commonly the lumbar spine, particularly the L4 and L5 vertebrae although brucella lesions of the spine can occur at any level. 4,6,9 ± 11 Spinal lesions multiple levels account for 9% of all cases. 10 In the other studies, between 11 and 80% of patients with brucellosis have bone and joint involvement and, of those, 6 to 54% have spinal column involvement 12 ± 14 most commonly a ecting the lumbar spine.…”

Section: Discussionmentioning

confidence: 99%

“…3 The earliest features are mild osteoporosis and epiphysitis localised in the anterio-superior angle, followed by narrowing of the joint space and involvement of the contiguous vertebral. 4,5 As the interosseous infection progresses with increasing vertebral body destruction, a delineating rim of sclerosis develops with subsequent anterior and lateral osteophytosis. 4 Posterior elements of the spine are rarely involved.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 As the interosseous infection progresses with increasing vertebral body destruction, a delineating rim of sclerosis develops with subsequent anterior and lateral osteophytosis. 4 Posterior elements of the spine are rarely involved. 4,6 Eventually, the spine stabilises with marked sclerosis and bony ankylosis in the majority of the cases.…”

Section: Introductionmentioning

confidence: 99%

“…4 Posterior elements of the spine are rarely involved. 4,6 Eventually, the spine stabilises with marked sclerosis and bony ankylosis in the majority of the cases. 4,5 Our experience with spinal brucellosis has been reviewed in an attempt to clarify issues such as diagnostic guidelines, treatment regimens, and e ect of rehabilitation on outcome.…”

Section: Introductionmentioning

confidence: 99%

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Management of spinal brucellosis and outcome of rehabilitation

Akansel

et al. 2001

Spinal Cord

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Study Design: Review of cases. Objective: To review cases of brucellosis in order to clarify diagnostic guidelines, treatment regimes and prognosis. Setting: University Hospital, Turkey. Methods: Study of 11 patients (9 male, 2 female) with either brucellar spondylitis or epidural brucellar abscess. Diagnosis made on clinical presentation, laboratory ®ndings, radiographic evidence and a minimum brucellar anti body of 1 : 160, a positive bacteriological culture and/ or histological ®nding of in¯ammation of granulomatous tissue. All patients were treated with a combination of oral antibiotics. Surgery was performed in 8 patients.Results: At least 6 months antibiotic therapy using Rifampicin and Doxycycline is recommended. Surgery is indicated in the presence of spinal instability, cord compression or radiculopathy. In our series eight patients required surgery. Conclusion: The patients complaining of back pain, particularly in endemic areas should be investigated as possible cases of brucellosis.

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Characteristic Cutaneous Lesions in Patients With Brucellosis

Ariza

Servitje²,

Pallarés³

et al. 1989

Arch Dermatol

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Among 436 cases of brucellosis included in a 12-year prospective protocol, we identified 27 patients (6%) with cutaneous lesions (13 men and 14 women; mean age, 35.1 +/- 16.5 years). Twenty-one patients had positive blood cultures for Brucella melitensis. A disseminated violet-erythematous, papulonodular eruption (20 cases) and erythema nodosum-like lesions (three cases) were the most frequent eruptions observed, appearing during the initial episode of the disease or in relapse. Histologic findings were a dermal inflammatory infiltrate of lymphocytes and histiocytes in a perivascular and periadnexal arrangement, with a focally granulomatous appearance, and occasional extension to subcutaneous fat. Skin cultures were positive for B melitensis in two of four cases. Our results suggest that there are characteristic clinical and histologic cutaneous findings in patients with brucellosis and that hematogenous spread of the microorganism can be the most important pathogenic mechanism of these lesions.

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Brucellar Spondylitis: A Detailed Analysis Based on Current Findings

Cited by 147 publications

References 20 publications

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

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

Management of spinal brucellosis and outcome of rehabilitation

Characteristic Cutaneous Lesions in Patients With Brucellosis

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