Brucellar Spondylitis: Review of 35 Cases and Literature Survey

Solera, J; Lozano, Elena; Martı́nez-Alfaro, Elisa; Espinosa, Alfredo; Castillejos, María Luisa; Abad, Lorenzo

doi:10.1086/313524

Cited by 245 publications

(231 citation statements)

References 40 publications

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“…Family history of brucellosis was reported in 9% to 51% of patients (15,24,46,48). Family screening leads to early diagnosis of the disease, which may prevent complications (49,50).…”

Section: Discussionmentioning

confidence: 99%

“…It has been recognized that brucellosis duration without adequate treatment is directly correlated with the complication rate and unfavorable outcome (41). A long period of symptomatic disease before therapeutic intervention was significantly more frequent in patients with brucellar spondylitis than in patients without spondylitis (12,48). The percentage of relapses among patients suffering from the disease for more than a month before therapy was higher than that among patients suffering from the disease for less than a month (29).…”

Section: Discussionmentioning

confidence: 99%

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Human Brucellosis in Macedonia – 10 Years of Clinical Experience in Endemic Region

Bosilkovski¹,

Krteva²,

Dimzova³

et al. 2010

Croat Med J

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Aim To present our 10-year clinical experience with brucellosis patients at the University Clinic for Infectious Diseases and Febrile Conditions in Skopje, Republic of Macedonia.Methods A total of 550 patients with brucellosis treated between 1998 and 2007 were retrospectively assessed for their demographic, epidemiological, and clinical characteristics and outcomes.Results Of the 550 patients, 395 (72%) were male. The median age was 34.5 years (range, 1-82). Direct contact with infected animals was recorded in 333 (61%) patients and positive family history in 310 (56%). The most frequently seen symptoms were arthralgia (438, 80%), fever (419, 76%), and sweating (394, 72%). The most common signs were fever and hepatomegaly, which were verified in 357 (65%) and 273 (50%) patients, respectively. Focal brucellosis was found in 362 patients (66%) and osteoarticular in 299 (54%). Therapeutic failures were registered in 37 (6.7%) patients. Of the 453 (82%) patients who completed a follow-up period of at least 6 months, relapses occurred in 60 (13%). ConclusionDue to non-specific clinical manifestation and laboratory parameters, brucellosis should be considered one of the differential diagnoses of any patient suffering from obscure involvement of various organs in a brucellosis-endemic region. High percentage of relapses and therapeutic failures in spite of the use of currently recommended therapeutic regimens indicates the seriousness of this zoonosis and the need to control it.

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“…Family history of brucellosis was reported in 9% to 51% of patients (15,24,46,48). Family screening leads to early diagnosis of the disease, which may prevent complications (49,50).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Human Brucellosis in Macedonia – 10 Years of Clinical Experience in Endemic Region

Bosilkovski¹,

Krteva²,

Dimzova³

et al. 2010

Croat Med J

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“…Peroperative cerebrospinal fluid leak is an unexpected and fearful complication during the surgical procedure for spinal epidural abscess due to Brucella infection. Although spread of Brucella is due to consumption of raw milk, local inoculation with direct contact is possible [11][12][13][14] . Iatrogenic inoculation of organism into the cerebrospinal fluid could induce distant innoculations.…”

Section: Discussionmentioning

confidence: 99%

“…Spinal epidural abscess is a rare complication in the course of spondylitis caused by Brucella species. The incidence of spondylitis in Brucellar infection is about 10%, however, development of spinal epidural abscess is rare 1,5,7,8,11,15 . Lumbar vertebrae are the most common region for epidural abscesses whereas involvement of the cervical spinal cord is uncommon.…”

Section: Introductionmentioning

confidence: 99%

Lumbar epidural abscess caused by brucella species: report of two cases

et al. 2009

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SummarySpinal epidural abscess due to Brucella species is usually associated with spondylodiscitis. Urgent surgical decompression should be performed in cases with moderate to severe neurological deficits particularly if progressive. We report clinical features of two cases operated for lumbar epidural abscess caused by Brucella species. Early surgical decompression combined with medical treatment could decrease progression of neurological findings or the severity of complications. Iatrogenic dural tear at the operation should be repaired immediately with fine sutures and fibrin tissue glue to prevent further innoculation into the cerebrospinal axis. These cases should be cautiously followed for any recurrence or neurobrucellosis.KEY WORDS: Epidural abscess. Brucellosis. Brucella spondylitis. Lumbar region. Surgery. Dural tear Absceso epidural lumbar causado por brucella: descripción de dos casos Resumen Los abscesos epidurales espinales debidos a Brucella se asocian habitualmente a espondilodiscitis. La descompresión quirúrgica urgente debe ser realizada en casos con déficit neurológico moderado o grave particularmente si este es progresivo. Describimos los aspectos clínicos de dos casos operados por abscesos epidurales causados por Brucella. El tratamiento quirúrgico temprano asociado con tratamiento médico puede disminuir la progresión de la sintomatología neurológica y la gravedad de las complicaciones. La aparición de desgarros durales durante la cirugía debe ser reparada de forma inmediata con sutura o pegamentos de fibrina para prevenir la inoculación dentro del neuroeje. Estos casos deben ser seguidos de forma cuidadosa para evitar la recurrencia de la neurobrucelosis.PALABRAS CLAVE: Absceso epidural. Brucelosis. Espondilitis por brucella. Región lumbar. Cirugía. Desgarro dural.

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“…Further, vertebral osteomyelitis caused by Mycobacteria other than M. tuberculosis and Brucellosis may also mimic Pott's disease [27][28][29].…”

Section: Diagnostic Imaging Sectionmentioning

confidence: 99%

A large tuberculosis abscess causing spinal cord compression of the cervico-thoracic region in a young child

et al. 2013

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Introduction Despite numerous descriptive publications, the guidelines for treatment of cervical spinal tuberculosis (TB) are not very clear. The authors report a case of a young girl with cervico-thoracic spinal TB extending from C5 to T3 vertebrae presenting with weakness of the right hand and unsteady gait. Case report An 11-year-old female who is an immigrant to the UK from Afghanistan, presented to our clinic with a 10-day history of difficulty in walking with an unsteady gait and 3-month history of progressive weakness in both her arms, the right side more affected than the left. Her immunisation history was unclear. Examination of the arms showed bilateral thenar and hypothenar wasting, more so on the right than the left. An MRI scan revealed a large para-spinal abscess extending from C3/4 to T4/5 with a significant anterior epidural cord compression from C5/6 to

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Brucellar Spondylitis: Review of 35 Cases and Literature Survey

Cited by 245 publications

References 40 publications

Human Brucellosis in Macedonia – 10 Years of Clinical Experience in Endemic Region

Human Brucellosis in Macedonia – 10 Years of Clinical Experience in Endemic Region

Lumbar epidural abscess caused by brucella species: report of two cases

A large tuberculosis abscess causing spinal cord compression of the cervico-thoracic region in a young child

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