Brucellar spondylodiscitis: A case series with focus on histopathological features

Rammeh, Soumaya; Riahi, Hend; Ksentini, Meriem; Bouaziz, Mouna Chelli; Ayadi, Rahma; Berriche, A.; Chebbi, Yosra; Ladeb, Mohamed Fethi

doi:10.1016/j.jocn.2020.05.046

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…Therefore, manifestations such as musculoskeletal pain, osteoarthritis, sacroiliitis, large joint involvement, spondylitis and discitis are expected. Previous studies showed that Brucella melitensis is the main species responsible for human brucellosis, thereby representing an important public health issue in many regions worldwide [ 5 , 12 ]. However, in this case we isolated the B. abortus from bulging disc infection for the first time, giving us an important overview on the Brucella species susceptible to induce this form of infection.…”

Section: Discussionmentioning

confidence: 99%

“…The most common clinical manifestations of human brucellosis are fever, chills, sweating, fatigue, headache, as well as musculoskeletal and joint pain. Moreover, lumbar area is the most commonly affected region in spinal brucellosis and represents one of the most important complications in human brucellosis [ 3 – 5 ]. Furthermore, brucellar discitis could occur through the intervertebral disc without spondylitis [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Isolation of Brucella abortus biovar 1 from human lumbar disc bulging: a case report of brucellar discitis

Alamian

Etemadi

Samiee³

et al. 2021

BMC Infect Dis

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Background Brucellosis is an endemic zoonotic disease with rising health and economic concerns in many areas worldwide. Musculoskeletal pains are among the main complications of human brucellosis, which are often difficult to diagnose due to the variability of clinical symptoms. Brucellar discitis is a very disabling problem in some chronic forms of the disease which may lead to serious vertebral and neurological consequences. Case presentation In this case report, we reported the isolation of Brucella abortus from lumbar disc bulging in a woman who had rheumatoid arthritis and diabetes mellitus as underlying conditions. The patient had several negative brucellosis serological tests and dorsolumbar pains with urinary incontinence over a 2-month period. The diagnosis was confirmed by magnetic resonance imaging (MRI) examination of lumbar spine as well as disc culture. MRI examination was performed without intravenous contrast and revealed the presence of disc bulging, left foraminal narrowing at L5-S1, left foraminal narrowing, anterolisthesis grade II at L4-L5. The diagnosis was also confirmed by isolation of B. abortus biovar 1 from bulging disc culture. The isolate was characterized by AMOS PCR, Bruce-ladder PCR and biotyping, resulting in the identification of B. abortus from L4-L5 and L5-S1 disc bulging regions. The patient was treated with two drugs i.e. doxycycline and rifampin for 3 months. In the follow-up, in addition to improving the patient’s general condition, low-back pain was also significantly reduced. Conclusions MRI, serology, cultural and molecular test along with patient history are important to make a rapid diagnosis of brucellosis’ discitis, thereby decreasing the delay for the brucellosis treatment. The present report suggests that the infection by Brucella spp. should be fundamentally considered among the causative agents of back pain especially in the endemic areas of Brucella infections.

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Section: Discussionmentioning

confidence: 99%